Individual provider Active NPI

Neda Rajablou

  • Endodontics
  • Boston, MA
National Provider Identifier
1033511050
Registry record updated Sep 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DL12359 Issued in MA
Practice address
100 E Newton St # G-705
Boston, MA 02118-2308
Phone
(617) 638-6613
NPI assigned
Sep 22, 2014
Last updated
Sep 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DL12359 MA Primary

Addresses

Primary practice location

100 E Newton St # G-705
Boston, MA 02118-2308

Mailing address

100 E Newton St # G-705
Boston, MA 02118-2308

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

LicenseStateTypeSpecialty
DL12359MAMDEndodontist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411344000000",
    "number": "1033511050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E NEWTON ST # G-705",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E NEWTON ST # G-705",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182308",
            "telephone_number": "617-638-6613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJABLOU",
        "first_name": "NEDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-22",
        "last_updated": "2014-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "DL12359",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.