NPIMap

Organization Active NPI

Diba Dastjerdi

  • Dentist
  • Swampscott, MA
National Provider Identifier
1326299702
Registry record updated Jan 6, 2009
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
21835 Issued in MA
Legal business name
DIBA DASTJERDI
Practice address
62 Burrill St
Swampscott, MA 01907-1903
Phone
(781) 599-4505
Fax
(781) 599-4945
NPI assigned
Oct 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2009

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

Authorized official

Name
Diba Dastjerdi, D.M.D
Title
Independant Contractor/Dentist
Phone
(781) 599-4505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 21835 MA Primary

Addresses

Primary practice location

62 Burrill St
Swampscott, MA 01907-1903

Mailing address

62 Burrill St
Swampscott, MA 01907-1903
Phone (781) 599-4505

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231200000000",
    "number": "1326299702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 BURRILL ST",
            "city": "SWAMPSCOTT",
            "state": "MA",
            "postal_code": "019071903",
            "telephone_number": "781-599-4505",
            "fax_number": "781-599-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 BURRILL ST",
            "city": "SWAMPSCOTT",
            "state": "MA",
            "postal_code": "019071903",
            "telephone_number": "781-599-4505",
            "fax_number": "781-599-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIBA DASTJERDI",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-03",
        "last_updated": "2009-01-06",
        "status": "A",
        "authorized_official_last_name": "DASTJERDI",
        "authorized_official_first_name": "DIBA",
        "authorized_official_title_or_position": "INDEPENDANT CONTRACTOR/DENTIST",
        "authorized_official_telephone_number": "781-599-4505",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "21835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swampscott, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; 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.