Active NPI
Altan Kihm
- Pediatric Dentistry
- Boston, MA
National Provider Identifier
1023539269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 35448
- Practice address
- 1 Keeland St
Boston, MA 02111 - Phone
- (617) 636-3898
- NPI assigned
- Jun 28, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 35448 | TX | Primary |
Addresses
Primary practice location
1 Keeland St
Boston, MA 02111
Mailing address
50 Rebecca LN
San Francisco, CA 94124-1726
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 122300000X | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35448 | TX | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564099200000",
"number": "1023539269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 REBECCA LN",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941241726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 KEELAND ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "02111",
"telephone_number": "617-636-3898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIHM",
"first_name": "ALTAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-28",
"last_updated": "2019-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "35448",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "122300000X",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.