NPIMap

Organization Active NPI

President and Fellows of Harvard College

  • General Practice Dentistry
  • Boston, MA
National Provider Identifier
1164512570
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17724 Issued in MA
Legal business name
PRESIDENT AND FELLOWS OF HARVARD COLLEGE
Practice address
188 Longwood Ave
Boston, MA 02115-5819
Phone
(617) 432-1434
Fax
(617) 432-4258
NPI assigned
Oct 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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

Authorized official

Name
Dr. John Da Silva, DMD
Title
Medical Director
Phone
(617) 432-1440

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X 12762 MA
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 17724 MA Primary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 16638 MA
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X 16484 MA
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 14710 MA
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 9239 MA

Addresses

Primary practice location

188 Longwood Ave
Boston, MA 02115-5819

Mailing address

188 Longwood Ave
Boston, MA 02115-5819
Phone (617) 432-1434

Other identifiers 1

IdentifierTypeStateIssuer
0200140MedicaidMA

Other names 1

  • Harvard Dental Center FGP Doing business as

National Provider Directory

National Provider Directory
Tax ID family
President Fellows of Harva17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455667200000",
    "number": "1164512570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155819",
            "telephone_number": "617-432-1434",
            "fax_number": "617-432-4258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155819",
            "telephone_number": "617-432-1434",
            "fax_number": "617-432-4258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESIDENT AND FELLOWS OF HARVARD COLLEGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-14",
        "last_updated": "2016-02-17",
        "status": "A",
        "authorized_official_last_name": "DA SILVA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "617-432-1440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "12762",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "17724",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "16638",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "MA",
            "license": "16484",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "14710",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "9239",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0200140",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harvard Dental Center FGP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; 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.