Sameka Dental Management

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21211 Issued in MA

Legal business name

SAMEKA DENTAL MANAGEMENT

Practice address

500 E Broadway
South Boston, MA 02127-4406

Phone

(617) 268-2333

Fax

(617) 268-8894

NPI assigned

Oct 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Ekaterina Mamulashvili, DMD

Title

Dentist

Phone

(617) 268-2333

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward Vance Geschelin, DMD

  • General Practice Dentistry
  • South Boston, MA
  • NPI 1942202023
  NPD (past)
• Gayle M Pezzulo, DMD

  • Dentist
  • South Boston, MA
  • NPI 1902925456
  NPD (past)
• Anshuman Singh Rawat, D.M.D.

  • General Practice Dentistry
  • Wrentham, MA
  • NPI 1245469949
  NPD (past)

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1205015179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E BROADWAY",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021274406",
            "telephone_number": "617-268-2333",
            "fax_number": "617-268-8894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E BROADWAY",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021274406",
            "telephone_number": "617-268-2333",
            "fax_number": "617-268-8894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMEKA DENTAL MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "MAMULASHVILI",
        "authorized_official_first_name": "EKATERINA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "617-268-2333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosengard Clinic
• Calvin C Ross, M.D.
• Katie Ryan
• Morgan Rymer, RN, FNP-BC
• Lisa Saint Cyr
• Julia Lynne Santos
• Sheel Saxena, MD
• Courtney Schoeplein
• Mark A Schroeder, LADCII
• Sandra Schultz, LICSW

• General Practice Dentistry in South Boston, MA
• Providers in South Boston, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; 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.