Individual provider Active NPI

Thuvaraka Thayaparan

  • General Practice Dentistry
  • Somerville, MA
National Provider Identifier
1063269140
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN10000255 Issued in MA
Practice address
20 Holland St Ste 400
Somerville, MA 02144-2749
Phone
(617) 676-0435
NPI assigned
May 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2844 ZZ
General Practice Dentistry 1223G0001X DN10000255 MA Primary

Addresses

Primary practice location

20 Holland St Ste 400
Somerville, MA 02144-2749

Mailing address

94 Maple St Apt 3
Malden, MA 02148-3849
Phone (347) 206-6615

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
2844ZZMDDentist
DN10000255MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1063269140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 MAPLE ST APT 3",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021483849",
            "telephone_number": "347-206-6615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HOLLAND ST STE 400",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442749",
            "telephone_number": "617-676-0435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAYAPARAN",
        "first_name": "THUVARAKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ZZ",
            "license": "2844",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN10000255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.