Active NPI
Inbal Dagan
- Pediatric Occupational Therapist
- Newton, MA
National Provider Identifier
1164188595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 114038
- Practice address
- 74 Bridge St
Newton, MA 02458-1147 - Phone
- (617) 539-8760
- NPI assigned
- Nov 10, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 114038 | MA | Primary |
Addresses
Primary practice location
74 Bridge St
Newton, MA 02458-1147
Mailing address
162 Kelton St
Allston, MA 02134-4466
Phone (508) 873-2547
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 |
|---|---|---|---|
| 114038 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636502400000",
"number": "1164188595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "162 KELTON ST",
"city": "ALLSTON",
"state": "MA",
"postal_code": "021344466",
"telephone_number": "508-873-2547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74 BRIDGE ST",
"city": "NEWTON",
"state": "MA",
"postal_code": "024581147",
"telephone_number": "617-539-8760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAGAN",
"first_name": "INBAL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-11-10",
"last_updated": "2021-11-10",
"certification_date": "2021-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist, Pediatrics",
"state": "MA",
"license": "114038",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.