Maryam Jessri, D.D.S, PH.D

Primary specialty

DentistTaxonomy code 122300000X

License

DL12659 Issued in MA

Practice address

1620 Tremont St
Oral Medicine and Dentistry, Suite BC-3-028
Boston, MA 02120-1613

Phone

(617) 732-6684

NPI assigned

Feb 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1194183434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 TREMONT ST",
            "address_2": "APT 512",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021201677",
            "telephone_number": "617-416-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 TREMONT ST",
            "address_2": "ORAL MEDICINE AND DENTISTRY, SUITE BC-3-028",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021201613",
            "telephone_number": "617-732-6684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSRI",
        "first_name": "MARYAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S, PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-01",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DL12659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Niels Jespersen
• Jessi Naff, LMHC Inc.
• Jessica Lau DMD PLLC
• Jessica Moy Wellness LLC
• Jessica Poulsen, PHD, PC
• Samuel Jessula, MD
• Chad Jason Jessup, M.D.
• Vanika Jethwa, LD/RD
• Hannah Jette
• Liam Jette, M.D.

• Dentist in Boston, MA
• Providers in Boston, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.