DR. LISA ANNE ANTONELLI (NPI# 1093892390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093892390 |
| Entity Type | Individual |
| Full Name | DR. LISA ANNE ANTONELLI |
| Credential | DMD |
| Practice Address |
330 Plantation Street Worcester MA 01604 |
| Practice Telephone | 5087531911 |
| Practice Fax Number | 5087531837 |
| Mailing Telephone | 5087531911 |
| Mailing Fax Number | 5087531837 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
16204 | MA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962577361 | Lisa M Antonelli | Nurse Practitioner | 266 Rindge Ave # B, Cambridge, MA 02140-3202 | 2006-11-21 |
| 1639169618 | Lisa F Antonelli | Internal Medicine | 2100 Dorchester Avenue, Smg - Carney Hospital, Dorchester, MA 02124 | 2005-10-21 |
| Street Address |
330 PLANTATION STREET |
| City | WORCESTER |
| State | MA |
| Zip Code | 01604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801988068 | Seta M Apelian | Dentist | 330 Plantation Street, Worcester, MA 01604 | 2006-09-28 |
| 1639261894 | University Dental Group PC | Dentist | 330 Plantation Street, Worcester, MA 01604 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942839832 | Nicole Elizabeth Lewandrowski | Student in an Organized Health Care Education/Training Program | Pathology-1 Innovation Drive, Biotech 3, Worcester, MA 01604 | 2020-04-03 |
| 1285123034 | Sandra Jean Golden | Social Worker | 240 Belmont Street, Worcester, MA 01604 | 2018-05-08 |
| 1669961348 | Cindy Truong Choe | Behavior Technician | 330 Southwest Cutoff Suite 203, Worcester, MA 01604 | 2018-05-08 |
| 1013412915 | Michelle Marie Gaudet | Behavioral Analyst | 330 Southwest Cutoff, Suite 203, Worcester, MA 01604 | 2018-03-24 |
| 1104336593 | Younghwa Kim | Counselor | 2 Granite Street, Worcester, MA 01604 | 2017-10-11 |
| 1134640857 | Desiree Oquendo | Developmental Therapist | 43 Dillon Street, Worcester, MA 01604 | 2017-07-03 |
| 1457803686 | Reliable Home Care Services | Foster Care Agency | 35a Houghton Strret, Worcester, MA 01604 | 2016-11-04 |
| 1639530876 | Emily Capstick | Counselor | 81 Plantation Steet, Worcester, MA 01604 | 2016-03-16 |
| 1144696519 | Christian Caban I | Developmental Therapist | 25 Orient St, Worcester, MA 01604 | 2015-08-19 |
| 1750770160 | Ayanna Ortiz | Developmental Therapist | 16 Bangor St, Worcester, MA 01604 | 2015-01-22 |
| Find all providers in zip 01604 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295217065 | Western Mass Perio | Dentist | 65 Elm St, Worcester, MA 01609-2547 | 2018-08-29 |
| 1023425808 | Commonwealth Periodontics | Dentist | 48 Elm St, Worcester, MA 01609-2541 | 2014-07-14 |
| 1285075614 | Todd Michael Jenny | Dentist | 405 Grove St, #300, Worcester, MA 01605-1270 | 2013-07-15 |
| 1881878403 | Eugene J. Mariani, Jr., D.d.s. | Dentist | 48 Elm St, Worcester, MA 01609-2541 | 2007-12-18 |
| 1487848362 | Elliot W Salloway | Dentist | 111 Elm St, Suite 203, Worcester, MA 01609-1967 | 2007-09-04 |
| 1487714812 | Carl Cohen Dmd PC | Dentist | 255 Park Ave, Suite 405, Worcester, MA 01609-1989 | 2006-12-08 |
| 1881760973 | Abraham W Haddad Dmd PC | Dentist | 250 Commercial Street, Suite 430, Worcester, MA 01608-1796 | 2006-11-28 |
| 1467525881 | David B Handsman | Dentist | 250 Commercial Street, Suite 430, Worcester, MA 01608-1796 | 2006-11-15 |
| 1588737902 | Abraham W Haddad | Dentist | 250 Commercial Street, Suite 430, Worcester, MA 01608-1796 | 2006-11-15 |
| 1497859870 | Rajiv Nanda | Dentist | 129 Lincoln St, Worcester, MA 01605 | 2006-09-07 |
| Find all providers in WORCESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.