Active NPI
Nicole S Critsinelis, DMD
- Pediatric Dentistry
- Newton Centre, MA
National Provider Identifier
1215600374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN10000068
- Practice address
- 792 Beacon St
Newton Centre, MA 02459-1977 - Phone
- (617) 655-9410
- NPI assigned
- Jul 26, 2021
- Last updated
- Sep 4, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 26266 | FL | |
| Pediatric Dentistry | 1223P0221X | DN26266 | FL | |
| Pediatric Dentistry | 1223P0221X | DN10000068 | MA | Primary |
Addresses
Primary practice location
792 Beacon St
Newton Centre, MA 02459-1977
Mailing address
30 Garrison St Apt 30-112
Boston, MA 02116-5741
Phone (954) 882-9209
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN26266 | FL | MD | Pediatric Dentist |
| DN10000068 | MA | MD | Pediatric Dentist |
| 26266 | FL | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bubble Children's Dentistry and Orthodontics | Pediatric Dentistry | Current | Accepting new patients |
Locations
792 Beacon St
Newton Centre, MA 02459
Phone (617) 655-9410
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.
-
- Pediatric Dentistry
- Newton Centre, MA
- NPI 1124602669
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756944000000",
"number": "1215600374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 GARRISON ST APT 30-112",
"city": "BOSTON",
"state": "MA",
"postal_code": "021165741",
"telephone_number": "954-882-9209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "792 BEACON ST",
"city": "NEWTON CENTRE",
"state": "MA",
"postal_code": "024591977",
"telephone_number": "617-655-9410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRITSINELIS",
"first_name": "NICOLE",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-26",
"last_updated": "2025-09-04",
"certification_date": "2025-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "26266",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "FL",
"license": "DN26266",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MA",
"license": "DN10000068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Newton Centre, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.