Active NPI
Roshanak Ghazinouri, D.M.D
- Orthodontics and Dentofacial Orthopedics Dentistry
- Brookline, MA
National Provider Identifier
1225233778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 17415
- Practice address
- 1037 Beacon St
Suite 2a
Brookline, MA 02446-5656 - Phone
- (617) 738-7210
- NPI assigned
- Jun 15, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 17415 | MA | Primary |
Addresses
Primary practice location
1037 Beacon St
Suite 2a
Brookline, MA 02446-5656
Mailing address
14 Wright St
Cambridge, MA 02138-1704
Phone (617) 256-6259
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0275506 | Medicaid | MA |
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 |
|---|---|---|---|
| 17415 | MA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1225233778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 WRIGHT ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021381704",
"telephone_number": "617-256-6259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1037 BEACON ST",
"address_2": "SUITE 2A",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024465656",
"telephone_number": "617-738-7210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHAZINOURI",
"first_name": "ROSHANAK",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MA",
"license": "17415",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0275506",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brookline, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.