Ava Ghassemi, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN1859156 Issued in MA

Practice address

209 Harvard St
Brookline, MA 02446-5071

Phone

(617) 277-3127

NPI assigned

Jun 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Ava Ghassemi-Tary Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Zhaleh J. Hami,DMD&Bahram Ghassemi Tary,D.M.D.,P.C.

  • Pediatric Dentistry
  • West Roxbury, MA
  • NPI 1699982645
  NPD (past)

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1073139184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 CENTRE ST",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021321535",
            "telephone_number": "617-327-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 HARVARD ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465071",
            "telephone_number": "617-277-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHASSEMI",
        "first_name": "AVA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "DN1859156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AVA",
            "last_name": "GHASSEMI-TARY",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• George S. Klavens, M.D., P.C.
• Gerald S. Fine, D.D.S.
• Diane Germano, APRN BC
• Kenneth Gershengorn, M.D.
• Reva L. Gertel, LICSW
• Mary Hanna Ghattas, D.M.D
• Mariam Ghavamian, D.M.D.
• Roshanak Ghazinouri, D.M.D
• Javad Ghoreishi, D.M.D.
• Paul M Ghostlaw, PT

• Pediatric Dentistry in Brookline, MA
• Providers in Brookline, MA by specialty
• Pediatric Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.