Individual provider Active NPI

Abol Massih Tehrani, DDS DMD CAGS

  • General Practice Dentistry
  • Haverhill, MA
National Provider Identifier
1902825144
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15329 Issued in MA
Practice address
121 Merrimack Street
Haverhill, MA 01830-6107
Phone
(978) 372-5011
Fax
(978) 372-5011
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15329 MA Primary

Addresses

Primary practice location

121 Merrimack Street
Haverhill, MA 01830-6107

Mailing address

121 Merrimack Street
Haverhill, MA 01830-6107
Phone (978) 372-5011

Other names 1

  • Dr. Abolghassem Massih Tehrani Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160621000589 MA Order and Referring Only - DentistPractitioner - Dentist 1052602133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902825144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 MERRIMACK STREET",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306107",
            "telephone_number": "978-372-5011",
            "fax_number": "978-372-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 MERRIMACK STREET",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306107",
            "telephone_number": "978-372-5011",
            "fax_number": "978-372-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEHRANI",
        "first_name": "ABOL",
        "middle_name": "MASSIH",
        "name_prefix": "Dr.",
        "credential": "DDS DMD CAGS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "15329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABOLGHASSEM",
            "last_name": "TEHRANI",
            "middle_name": "MASSIH",
            "prefix": "DR.",
            "credential": "DDS DMD CAGS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Haverhill, MA

Sources for this page

Verify at the official NPI Registry.