Kathleen E. Barrett
Individual provider Active NPI Periodontics · Newton Centre, MA
NPI 1184045965 · NPPES record last updated Dec 23, 2013
Key facts
- NPI
- 1184045965
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Periodontics 1223P0300X
- License
- 16115 (MA)
- Practice address
- 345 Boylston St
Suite 401
Newton Centre, MA 02459-2863 - Phone
- (617) 965-3830
- NPI assigned
- Dec 23, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170104001655 | MA | Order and Referring Only - Maxillofacial Surgery |
5092096115 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16115 | MA | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kathleen E. Barrett, D.M.D.,P.C. | Periodontics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 16115 | MA | Yes |
Addresses
Primary practice location
345 Boylston St
Suite 401
Newton Centre, MA 02459-2863
Mailing address
345 Boylston St
Suite 401
Newton Centre, MA 02459-2863
Other providers in Newton Centre, MA
- Salvatore Angelo II
- Cynthia Louise Ardito Fields
- Steven Roy Bader
- Baek Dental, P.C.
- Paul Woojong Baek
- Barry J Goldberg DMD PC
- Barry J Goldberg DMD PC
- Jonathan A Benjamin
- Anna Berik
- Gregory Keith Binus
All providers in Newton Centre, MA · Periodontics in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 23, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.