Individual provider Active NPI

Merialda Tahiraga, R.D.H.

  • Dental Hygienist
  • Roslindale, MA
National Provider Identifier
1154739720
Registry record updated Jul 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
13361 Issued in MA
Practice address
4199 Washington St
Roslindale, MA 02131-2733
Phone
(617) 323-4440
Fax
(617) 323-7870
NPI assigned
Jul 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 13361 MA Primary

Addresses

Primary practice location

4199 Washington St
Roslindale, MA 02131-2733

Mailing address

4199 Washington St
Roslindale, MA 02131-1752
Phone (617) 323-4440

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

LicenseStateTypeSpecialty
13361MAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406505600000",
    "number": "1154739720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4199 WASHINGTON ST",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021311752",
            "telephone_number": "617-323-4440",
            "fax_number": "617-323-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4199 WASHINGTON ST",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021312733",
            "telephone_number": "617-323-4440",
            "fax_number": "617-323-7870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHIRAGA",
        "first_name": "MERIALDA",
        "credential": "R.D.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2014-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MA",
            "license": "13361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslindale, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2014; 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.