Organization Active NPI

Mahmoud El Hadidy, DMD, PHD, PC

Doing business as Back Bay Oral& Maxillofacial Surgery

  • Oral and Maxillofacial Surgery Clinic/Center
  • Boston, MA
National Provider Identifier
1265568174
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
License
19353 Issued in MA
Legal business name
MAHMOUD EL HADIDY, DMD, PHD, PC
Doing business as
Back Bay Oral& Maxillofacial Surgery
Practice address
311 Commonwealth Ave
Suite 10
Boston, MA 02115-1926
Phone
(617) 267-4777
Fax
(617) 267-1277
NPI assigned
Feb 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mahmoud A El Hadidy, DMD, PHD
Title
President
Phone
(617) 267-4777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X 19353 MA Primary

Addresses

Primary practice location

311 Commonwealth Ave
Suite 10
Boston, MA 02115-1926

Mailing address

311 Commonwealth Ave
Suite 10
Boston, MA 02115-1926
Phone (617) 267-4777

Other names 1

  • Back Bay Oral& Maxillofacial Surgery Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265568174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 COMMONWEALTH AVE",
            "address_2": "SUITE 10",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021151926",
            "telephone_number": "617-267-4777",
            "fax_number": "617-267-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 COMMONWEALTH AVE",
            "address_2": "SUITE 10",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021151926",
            "telephone_number": "617-267-4777",
            "fax_number": "617-267-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHMOUD EL HADIDY, DMD, PHD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EL HADIDY",
        "authorized_official_first_name": "MAHMOUD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-267-4777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, PHD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "19353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back Bay Oral& Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.