Paolo Junior Fantozzi, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DL13898 Issued in MA

Practice address

75 Francis St
Boston, MA 02115-6110

Phone

(617) 732-6570

NPI assigned

Feb 20, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1285190744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 TREMONT ST STE BC-3028",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021201613",
            "telephone_number": "617-732-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTOZZI",
        "first_name": "PAOLO JUNIOR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-20",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DL13898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FNTPJN90R19B114V",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Francisco Eduardo Fantes Jr., M.D.
• Thomas Peter Fantes, MD
• Chad Fanti, MD
• Fanton Consulting, Inc.
• Maria Loretta Fantozzi
• Kristina Ann Fanucci, MD
• Kamli Noelle Wafic Faour
• William C Faquin, MD PHD
• Amy Helena Farabaugh, PHD
• Ahmed Farag, MD

• Dentist in Boston, MA
• Providers in Boston, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.