Individual provider Active NPI

Niusha Nikkholgh

  • Dentist
  • Franklin, MA
National Provider Identifier
1215465224
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1857688 Issued in MA
Practice address
151 E Central St
Franklin, MA 02038-1439
Phone
(508) 520-8777
NPI assigned
Jun 3, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1857688 MA Primary

Addresses

Primary practice location

151 E Central St
Franklin, MA 02038-1439

Mailing address

151 E Central St
Franklin, MA 02038-1439

Other practice location 1

632 Blue Hill Ave
Dorchester, MA 02121-3213
Phone (617) 825-3400

Other practice location 2

632 Blue Hill Ave
Dorchester, MA 02121-3213
Phone (617) 825-3400

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220427001631 MA Order and Referring Only - Other (Non-Physician) 6709273477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sudbury Endodontics LLC Current Accepting new patients
Endodontic Care of Ma, P.C. PastSince Nov 22, 2020 Accepting new patients
Dental Dreams, LLC Dentist Past Accepting new patients

Organizations & group practices 3

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": "1496448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1215465224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 E CENTRAL ST",
            "city": "FRANKLIN",
            "state": "MA",
            "postal_code": "020381439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 E CENTRAL ST",
            "city": "FRANKLIN",
            "state": "MA",
            "postal_code": "020381439",
            "telephone_number": "508-520-8777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "632 Blue Hill Ave",
            "address_purpose": "LOCATION",
            "city": "Dorchester",
            "state": "MA",
            "postal_code": "021213213",
            "country_code": "US",
            "telephone_number": "617-825-3400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "632 Blue Hill Ave",
            "address_purpose": "LOCATION",
            "city": "Dorchester",
            "state": "MA",
            "postal_code": "021213213",
            "country_code": "US",
            "telephone_number": "617-825-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIKKHOLGH",
        "first_name": "NIUSHA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-03",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1857688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, MA

Sources for this page

Verify at the official NPI Registry.