Individual provider Active NPI

Atheer Binzouman

  • Periodontics
  • Boston, MA
National Provider Identifier
1184275885
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DL14154 Issued in MA
Practice address
650 Albany St
Boston, MA 02118-2518
Phone
(617) 358-8300
NPI assigned
Sep 24, 2019
Last updated
Sep 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DL14154 MA Primary

Addresses

Primary practice location

650 Albany St
Boston, MA 02118-2518

Mailing address

650 Albany St
Boston, MA 02118-2518
Phone (617) 358-8300

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

LicenseStateTypeSpecialty
DL14154MAMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1184275885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182518",
            "telephone_number": "617-358-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182518",
            "telephone_number": "617-358-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BINZOUMAN",
        "first_name": "ATHEER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "DL14154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 24, 2019; 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.