Individual provider Active NPI

Aidis S. Kozica, D.D.S.

  • General Practice Dentistry
  • Worcester, MA
National Provider Identifier
1962487736
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17500 Issued in MA
Practice address
116 Belmont St
Ste. 23
Worcester, MA 01605-2964
Phone
(508) 755-0751
Fax
(508) 755-5532
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 17500 MA Primary

Addresses

Primary practice location

116 Belmont St
Ste. 23
Worcester, MA 01605-2964

Mailing address

116 Belmont St
Ste. 23
Worcester, MA 01605-2964
Phone (508) 755-0751

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
I20150508000442 MA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6103145495

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17500MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1962487736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 BELMONT ST",
            "address_2": "STE. 23",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052964",
            "telephone_number": "508-755-0751",
            "fax_number": "508-755-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 BELMONT ST",
            "address_2": "STE. 23",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052964",
            "telephone_number": "508-755-0751",
            "fax_number": "508-755-5532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZICA",
        "first_name": "AIDIS",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "17500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.