Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Ross USA Icyda, DMD

Individual provider Dentist · NPI 1205179421

Dr. Ross USA Icyda, DMD is an Oral Surgery in Boston, Massachusetts. Graduated from Tufts University School of Dental Medicine in 2011, 15 years ago. Practices with Massachusetts General Physicians Organization Inc, a 3,484-clinician group and accepts Medicare assignment. Licensed in Florida, Massachusetts and Oregon.

Years since qualifying
15
Trained at
Tufts University School of Dental Medicine
Licensed in
FL, MA, OR
In the registry since
2013
Specialties on file
3
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

165 Cambridge St Ste 401
Boston, MA 02114-2783
Phone: (617) 726-1076
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence DN1856767 (MA)
Dentist Taxonomy 122300000X · Licence D9790 (OR)
Dentist Taxonomy 122300000X · Licence DN 19965 (FL)

Record details

NPI number1205179421
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedApril 5, 2013
Last updated in NPPESAugust 19, 2016
Mailing address165 Cambridge St, Ste 401, Boston, MA 02114-2750

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORAL SURGERY
Medical schoolTUFTS UNIVERSITY SCHOOL OF DENTAL MEDICINE
Graduated 2011 (15 years in practice)
Group practice Massachusetts General Physicians Organization Inc — 3484 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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