Individual provider Active NPI

Marc B Ehrlich, DMD

  • Prosthodontics
  • Brookline, MA
National Provider Identifier
1205020260
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
15532 Issued in MA
Practice address
1371 Beacon St
Suite 201
Brookline, MA 02446-4905
Phone
(617) 566-2734
NPI assigned
Sep 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 15532 MA Primary

Addresses

Primary practice location

1371 Beacon St
Suite 201
Brookline, MA 02446-4905

Mailing address

1371 Beacon St
Suite 201
Brookline, MA 02446-4905
Phone (617) 566-2734

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
I20150521000203 MA Order and Referring Only - DentistPractitioner - Dentist 6709106438

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15532MAMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Ehrlich Dental Associates Inc Prosthodontics Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1205020260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 BEACON ST",
            "address_2": "SUITE 201",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464905",
            "telephone_number": "617-566-2734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 BEACON ST",
            "address_2": "SUITE 201",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464905",
            "telephone_number": "617-566-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRLICH",
        "first_name": "MARC",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MA",
            "license": "15532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.