Active NPI
Amit Mehra, DMD
- General Practice Dentistry
- East Boston, MA
National Provider Identifier
1245525385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN1855700
- Practice address
- 55 Meridian St
East Boston, MA 02128-1959 - Phone
- (617) 567-1300
- NPI assigned
- Jun 16, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN1855700 | MA | Primary |
Addresses
Primary practice location
55 Meridian St
East Boston, MA 02128-1959
Mailing address
1016 Canyon Ridge Dr
Broad Brook, CT 06016-5605
Phone (617) 834-0111
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171129000061 | MA | Order and Referring Only - Dentist | 3274890322 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN1855700 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332374400000",
"number": "1245525385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1016 CANYON RIDGE DR",
"city": "BROAD BROOK",
"state": "CT",
"postal_code": "060165605",
"telephone_number": "617-834-0111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 MERIDIAN ST",
"city": "EAST BOSTON",
"state": "MA",
"postal_code": "021281959",
"telephone_number": "617-567-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEHRA",
"first_name": "AMIT",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-16",
"last_updated": "2012-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "DN1855700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.