Active NPI
Narendra Mohandas Nagalla, BDS
- General Practice Dentistry
- Massachusetts, MA
National Provider Identifier
1174273247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DL15142
- Practice address
- 635 Albany St
Boston
Massachusetts, MA 02118 - Phone
- (617) 358-8300
- NPI assigned
- Mar 24, 2022
- Last updated
- Mar 24, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DL15142 | MA | Primary |
Addresses
Primary practice location
635 Albany St
Boston
Massachusetts, MA 02118
Mailing address
2001 Falls Blvd Apt 133
Quincy, MA 02169-8212
Phone (317) 319-4446
Other practice location 1
1200 Center St
Roslindale
Massachusetts, MA 02118
Phone (617) 363-8000
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 |
|---|---|---|---|
| DL15142 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648080000000",
"number": "1174273247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2001 FALLS BLVD APT 133",
"city": "QUINCY",
"state": "MA",
"postal_code": "021698212",
"telephone_number": "317-319-4446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "635 ALBANY ST",
"address_2": "BOSTON",
"city": "MASSACHUSETTS",
"state": "MA",
"postal_code": "02118",
"telephone_number": "617-358-8300"
}
],
"practiceLocations": [
{
"address_1": "1200 Center St",
"address_2": "Roslindale",
"address_purpose": "LOCATION",
"city": "Massachusetts",
"state": "MA",
"postal_code": "02118",
"country_code": "US",
"telephone_number": "617-363-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NAGALLA",
"first_name": "NARENDRA",
"middle_name": "MOHANDAS",
"name_prefix": "Dr.",
"credential": "BDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-24",
"last_updated": "2022-03-24",
"certification_date": "2022-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "DL15142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.