Individual provider Active NPI

Noosha Khadivi, DMD

  • General Practice Dentistry
  • Webster, MA
National Provider Identifier
1194129437
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1856745 Issued in MA
Practice address
50 Thompson Rd
Webster, MA 01570-1408
Phone
(508) 943-8111
NPI assigned
Oct 15, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN1856745 MA Primary

Addresses

Primary practice location

50 Thompson Rd
Webster, MA 01570-1408

Mailing address

15 Morgan Dr Unit 301
Natick, MA 01760-4296
Phone (781) 243-1028

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
I20150716000409 MA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1759694094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1856745MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
University Dental of Webster PLLC PastSince Apr 25, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1194129437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MORGAN DR UNIT 301",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017604296",
            "telephone_number": "781-243-1028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 THOMPSON RD",
            "city": "WEBSTER",
            "state": "MA",
            "postal_code": "015701408",
            "telephone_number": "508-943-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHADIVI",
        "first_name": "NOOSHA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-15",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1856745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, MA

Sources for this page

Verify at the official NPI Registry.