Active NPI
Taym Almetwali, DMD
- Dentist
- Lebanon, NH
National Provider Identifier
1104591502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN1859722
- Practice address
- 367 Route 120 Unit C
Lebanon, NH 03766-1430 - Phone
- (603) 782-0329
- NPI assigned
- Aug 9, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 04681 | NH | |
| Dentist | 122300000X | DN1859722 | MA | Primary |
Addresses
Primary practice location
367 Route 120 Unit C
Lebanon, NH 03766-1430
Mailing address
12 Post Office SQ
Boston, MA 02109-3924
Phone (603) 782-0329
Other practice location 1
12 Post Office Sq
Boston, MA 02109-3924
Phone (212) 686-3686
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN1859722 | MA | MD | Dentist |
| 04681 | NH | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Bridge Dental Ma PLLC | General Practice | Current | Accepting new patients |
Locations
12 Post Office Sq
Boston, MA 02109
Phone (617) 542-8808
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735862400000",
"number": "1104591502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 POST OFFICE SQ",
"city": "BOSTON",
"state": "MA",
"postal_code": "021093924",
"telephone_number": "603-782-0329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "367 ROUTE 120 UNIT C",
"city": "LEBANON",
"state": "NH",
"postal_code": "037661430",
"telephone_number": "603-782-0329"
}
],
"practiceLocations": [
{
"address_1": "12 Post Office Sq",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021093924",
"country_code": "US",
"telephone_number": "212-686-3686",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ALMETWALI",
"first_name": "TAYM",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-09",
"last_updated": "2025-01-03",
"certification_date": "2025-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "NH",
"license": "04681",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN1859722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lebanon, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.