NPI 1508943382 · live from the CMS NPI Registry
Lagina Dawn Bickham, DMD
Dentist, General Practice in Roxbury, MA. National Provider Identifier 1508943382, active.
NPI record
| NPI | 1508943382 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 55 Dimock St, Roxbury, MA 02119 |
| Practice phone | 617-442-8800 |
| Mailing address | 17 Dryden Ave, Pawtucket, RI 02860 |
| Enumerated | November 1, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, General Practice primary | 1223G0001X | D18179 (MA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.