Individual provider Active NPI

Mohsen Akhavan

  • Dentist
  • Boston, MA
National Provider Identifier
1316527328
Registry record updated May 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1859719 Issued in MA
Practice address
231 Harrison Ave Apt 6
Boston, MA 02111-1856
Phone
(424) 394-6880
NPI assigned
Apr 13, 2021
Last updated
May 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DL14784 MA
Dentist 122300000X DN1859719 MA Primary

Addresses

Primary practice location

231 Harrison Ave Apt 6
Boston, MA 02111-1856

Mailing address

231 Harrison Ave Apt 6
Boston, MA 02111-1856
Phone (424) 394-6880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DL14784MAMDDentist
DN1859719MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683936000000",
    "number": "1316527328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 HARRISON AVE APT 6",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111856",
            "telephone_number": "424-394-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 HARRISON AVE APT 6",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111856",
            "telephone_number": "424-394-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKHAVAN",
        "first_name": "MOHSEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-13",
        "last_updated": "2023-05-13",
        "certification_date": "2023-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DL14784",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1859719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 13, 2023; 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.