Individual provider Active NPI

Priya Cheruvathur, DMD

  • Dentist
  • Braintree, MA
National Provider Identifier
1174092969
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1858168 Issued in MA
Practice address
414 John Mahar Hwy Unit 201
Braintree, MA 02184-6566
Phone
(781) 964-2474
NPI assigned
Nov 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1858168 MA Primary

Addresses

Primary practice location

414 John Mahar Hwy Unit 201
Braintree, MA 02184-6566

Mailing address

414 John Mahar Hwy Unit 201
Braintree, MA 02184-6566
Phone (781) 964-2474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190123004215 MA Order and Referring Only - DentistPractitioner - Dentist 2062759426

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1174092969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 JOHN MAHAR HWY UNIT 201",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021846566",
            "telephone_number": "781-964-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 JOHN MAHAR HWY UNIT 201",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021846566",
            "telephone_number": "781-964-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERUVATHUR",
        "first_name": "PRIYA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-21",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1858168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Braintree, MA

Sources for this page

Verify at the official NPI Registry.