Imran Chitalwalla

Primary specialty

DentistTaxonomy code 122300000X

License

DN1857075 Issued in MA

Practice address

951 Tremont St
Boston, MA 02120-2210

Phone

(617) 708-1686

NPI assigned

Jun 26, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1083029102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "691 MASSACHUSETTS AVE",
            "address_2": "APARTMENT 102",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184077",
            "telephone_number": "857-225-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 TREMONT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021202210",
            "telephone_number": "617-708-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHITALWALLA",
        "first_name": "IMRAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-26",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1857075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSHEALTH",
            "identifier": "10104875A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bridget Chisholm, PHARMD
• Harold Chisholm, OPTICIAN
• Hillary Anne Chisholm, RN, APRN, MPH
• Margaret Ellen Chisholm, LICSW
• Vipul C. Chitalia, MD
• Hovig Vatche Chitilian, MD
• Pooja R Chitneni, MD
• Tanuja Chitnis, MD
• Anuradha Chittenden, M.S.
• Melissa Dawn Chittle, PA-C

• Dentist in Boston, MA
• Providers in Boston, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.