Unknown Individual – Dentist, NPI 1093890790

Unknown Individual is a healthcare provider. based in Danvers, Massachusetts. specializing in Dentist. They hold a License No. 11651 (MA). The NPI Number for Unknown Individual is 1093890790

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1093890790
Phone
(978) 777-2626
Address
140 COMMONWEALTH AVE
Deactivation Date
3 April 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 140, Commonwealth Avenue, Liberty Tree Mall, Tapleyville, Danvers, Essex County, Massachusetts, 01923, United States

    SUITE 204

    DANVERS, MA 019233629

    Phone: (978) 777-2626

    Type: Location

  • 2118, Massachusetts Avenue, Lexington, Middlesex County, Massachusetts, 02421, United States

    LEXINGTON, MA 024214507

    Phone: (781) 862-4203

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 01923)

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Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1093890790 is assigned to Unknown Individual under the national enumeration system.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Dentist. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Danvers, Massachusetts for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1093890790. Always confirm identity and privileges with the practice and licensing boards.

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