DR. PETER ALAN JEZEWSKI (NPI# 1730102088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730102088 |
| Entity Type | Individual |
| Full Name | DR. PETER ALAN JEZEWSKI |
| Credential | DDS PHD |
| Practice Address |
100 Everett Ave Unit 5 Chelsea MA 02150 |
| Mailing Address |
140 The Fenway The Forsyth Institute Room 411 Boston MA 02115 |
| Practice Telephone | 6178844444 |
| Practice Fax Number | 6178844448 |
| Mailing Telephone | 6178928491 |
| Mailing Fax Number | 6178928303 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
21238 | MA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 0204544 | 05 |
| Street Address |
100 EVERETT AVE UNIT 5 |
| City | CHELSEA |
| State | MA |
| Zip Code | 02150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750363768 | Dean C Xerras | Internal Medicine | 100 Everett Ave, Suite 16c, Chelsea Healthcare Center, Chelsea, MA 02150-2309 | 2005-11-16 |
| 1386258804 | Ronald L Blackwell | Student in an Organized Health Care Education/Training Program | 100 Everett Ave, Mgh Chelsea Health Center, Chelsea, MA 02150-2309 | 2020-09-02 |
| 1194223388 | Special Hands Home Care, Inc | Home Health | 100 Everett Ave, Chelsea, MA 02150-2309 | 2018-01-23 |
| 1881140176 | Christine Shaughnessy | Nurse Practitioner | 100 Everett Ave, Chelsea, MA 02150-2309 | 2016-08-28 |
| 1245689421 | Pranav Kaushish | Dentist | 100 Everett Ave, Suite 5, Chelsea, MA 02150-2309 | 2016-06-08 |
| 1184000218 | Jubin Zaboulian | Dentist | 100 Everett Ave, #5, Chelsea, MA 02150-2309 | 2015-07-30 |
| 1922369933 | Susan Inonog | Internal Medicine | 100 Everett Ave, Chelsea, MA 02150-2309 | 2012-06-06 |
| 1326232018 | Carole Shapiro | Speech-Language Pathologist | 100 Everett Ave, Chelsea, MA 02150-2309 | 2007-09-05 |
| 1699983601 | Lisa Teixeira | Counselor | 100 Everett Ave, Unit 4, Chelsea, MA 02150-2309 | 2007-05-21 |
| 1215156039 | Elsa V. Garcia | Counselor | 100 Everett Ave, Unit 4, Chelsea, MA 02150-2309 | 2007-04-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013540020 | Freyre Figueroa | Counselor | 324 Broadway Apt # Broadway, Chelsea, MA 02150 | 2020-02-18 |
| 1255816740 | Alexander Tsonas | Social Worker | Seaport Academy, 285 Commandants Way, Chelsea, MA 02150 | 2018-10-01 |
| 1669969069 | Kimberly Huffer | Social Worker | 17 Tudor St, Chelsea, MA 02150 | 2018-04-20 |
| 1518468099 | Gladys G. Carrasco Roman | Dentist | 180 Walnut Street, Chelsea, MA 02150 | 2018-02-21 |
| 1700238557 | Healing Hands | Foster Care Agency | 45 Gillooly Road, Chelsea, MASSACHUSETTS (MA) 02150 | 2016-07-05 |
| 1932577293 | Ashlie Lynn | Physical Therapy Assistant | 255 Central Avenue, Chelsea, MA 02150 | 2015-09-03 |
| 1720464043 | Kali Stewart | Dentist | 950 Broadway Apt 1c, Chelsea, MA 02150 | 2015-08-10 |
| 1780068452 | Keishla Rivera | Preferred Provider Organization | 135 Shawmut St, Chelsea, MA 02150 | 2015-07-13 |
| 1265856066 | Aftercare Services, Inc | Home Health | 125-135 Library St., Chelsea, MA 02150 | 2014-02-13 |
| 1003164732 | Michele Carmi | Social Worker | 310 Brodway, Chelsea, MA 02150 | 2012-08-28 |
| Find all providers in zip 02150 | ||||
| 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 |
|---|---|---|---|---|
| 1578002812 | Michigan Periodontics Group LLC | Dentist | 350 N Main St Ste 110, Chelsea, MI 48118-1486 | 2017-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871134833 | Supontep Teerakanok | Dentist | Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118 | 2019-10-01 |
| 1437700218 | Mansour Alasiri | Dentist | 650 Albany St Ste 341, Boston, MA 02118-2518 | 2019-09-24 |
| 1508417338 | Bushra Aljahdali | Dentist | 650 Albany St Fl 3, Boston, MA 02118-2518 | 2019-09-23 |
| 1164077152 | North Shore Smiles LLC | Dentist | 293 Humphrey Str., Swampscott, MA 01907 | 2019-08-06 |
| 1790330298 | Cambridge Periodontics LLC | Dentist | 1692 Massachusetts Ave Ste 3, Cambridge, MA 02138 | 2019-08-02 |
| 1043863533 | Ricardo Lazaro Pascual | Dentist | 1 Kneeland St Dept, Boston, MA 02111-1527 | 2019-07-23 |
| 1568014827 | David B Rosen Dmd | Dentist | 57 Bedford St Ste 110, Lexington, MA 02420-4550 | 2019-07-16 |
| 1396209961 | Gabriel Boustani Dmd PC | Dentist | 822 Boylston St Ste 200, Chestnut Hill, MA 02467-2504 | 2019-01-28 |
| 1568935153 | Periodontology Associates of Concord, Pllc | Dentist | 290 Baker Ave Ste 3, Concord, MA 01742-2189 | 2019-01-07 |
| 1467925057 | Periodontology Associates of Lexington, Pllc | Dentist | 35 Bedford St Ste 20, Lexington, MA 02420-4440 | 2019-01-07 |
| Find all providers with the same taxonomy | ||||
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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.