Individual provider Active NPI

Rekha Hariawala, D.M.D.

  • General Practice Dentistry
  • Boston, MA
National Provider Identifier
1265455430
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19152 Issued in MA
Practice address
1601 Washington Street
Boston, MA 02118-1951
Phone
(617) 425-2000
Fax
(617) 424-8725
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

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 19152 MA Primary

Addresses

Primary practice location

1601 Washington Street
Boston, MA 02118-1951

Mailing address

1601 Washington St
Boston, MA 02118-1951
Phone (617) 425-2000

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
I20160426000259 MA Order and Referring Only - DentistPractitioner - Dentist 1254630247

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19152MAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321315200000",
    "number": "1265455430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021181951",
            "telephone_number": "617-425-2000",
            "fax_number": "617-424-8725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WASHINGTON STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021181951",
            "telephone_number": "617-425-2000",
            "fax_number": "617-424-8725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARIAWALA",
        "first_name": "REKHA",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2011-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "19152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.