Individual provider Active NPI

Harvey Ashor Shaff, DMD

  • General Practice Dentistry
  • Chestnut Hill, MA
National Provider Identifier
1235147166
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11287 Issued in MA
Practice address
25 Boylston St
Suite L15
Chestnut Hill, MA 02467
Phone
(617) 566-6900
Fax
(617) 566-0629
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11287 MA Primary

Addresses

Primary practice location

25 Boylston St
Suite L15
Chestnut Hill, MA 02467

Mailing address

25 Boylston St
Suite L15
Chestnut Hill, MA 02467
Phone (617) 566-6900

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
I20160414001614 MA Order and Referring Only - DentistPractitioner - Dentist 8729386305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11287MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Polivy Dental Enterprises, PC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235147166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BOYLSTON ST",
            "address_2": "SUITE L15",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "02467",
            "telephone_number": "617-566-6900",
            "fax_number": "617-566-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 BOYLSTON ST",
            "address_2": "SUITE L15",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "02467",
            "telephone_number": "617-566-6900",
            "fax_number": "617-566-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFF",
        "first_name": "HARVEY",
        "middle_name": "ASHOR",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "11287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestnut Hill, MA

Sources for this page

Verify at the official NPI Registry.