Individual provider Active NPI

Hetal Rana

  • Dentist
  • Chelsea, MA
National Provider Identifier
1063812121
Registry record updated Sep 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1856684 Issued in MA
Practice address
357 Broadway
Chelsea, MA 02150-2807
Phone
(617) 515-2779
NPI assigned
Aug 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1856684 MA Primary

Addresses

Primary practice location

357 Broadway
Chelsea, MA 02150-2807

Mailing address

36 Dartmouth St
Apt #1002
Malden, MA 02148-5112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160422002041 MA Order and Referring Only - DentistPractitioner - Dentist 8820397904

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1856684MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410307200000",
    "number": "1063812121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 DARTMOUTH ST",
            "address_2": "APT #1002",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 BROADWAY",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "021502807",
            "telephone_number": "617-515-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANA",
        "first_name": "HETAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2014-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1856684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelsea, MA

Sources for this page

Verify at the official NPI Registry.