East Boston Dental and Orthodontics PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

EAST BOSTON DENTAL AND ORTHODONTICS PC

Practice address

999 Saratoga St
East Boston, MA 02128-1238

Phone

(617) 569-2761

Fax

(617) 997-0030

NPI assigned

Oct 6, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Neetu Bansal, DMDNPI 1376630145

Title

Owner

Phone

(617) 275-6306

Specialties & licenses 4

Addresses

Other names 1

• EAST BOSTON DENTAL AND ORTHODONTICS PC Doing business as

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Neetu Bansal, DMD

  • Dentist
  • Salem, MA
  • NPI 1376630145
  NPD (past) Authorized official

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

{
    "created_epoch": "1570320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691625600000",
    "number": "1104467612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 BRIGHTON ST APT 3",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021291260",
            "telephone_number": "617-275-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 SARATOGA ST",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021281238",
            "telephone_number": "617-569-2761",
            "fax_number": "617-997-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BOSTON DENTAL AND ORTHODONTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-06",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A",
        "authorized_official_last_name": "BANSAL",
        "authorized_official_first_name": "NEETU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-275-6306",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EAST BOSTON DENTAL AND ORTHODONTICS PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EAST BOSTON DENTAL AND ORTHODONTICS PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kozeta Durishti
• Anne Dwyer-Wilmer, MD
• Sarah Elizabeth Dybizbanski
• East Boston Behavioral Health and Medicine LLC
• East Boston Chiropractic and Rehabilitation Clinic, Inc.
• East Boston Family Dental Center
• East Boston Family Wellness Center, Inc.
• East Boston Physical Therapy Center, Inc.
• Deborah Ann Eccleston
• Carlos Echevarria Maldonado, PHARMD

• General Practice Dentistry in East Boston, MA
• Providers in East Boston, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.