Sevara Mamadalimova

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12014241A Issued in IN

Practice address

635 Albany St
Boston, MA 02118

Phone

(617) 358-8360

NPI assigned

Dec 16, 2021

Sex

Female

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 2

Electronic endpoints 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": "1639612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1346909462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 HARRISON AVE APT 110",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-358-8360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMADALIMOVA",
        "first_name": "SEVARA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-16",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12014241A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA DENTAL BOARD",
            "identifier": "12014241A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSACHUSETTS DENTAL LICENSE - LIMITED LICENSE",
            "identifier": "DL14967",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.budentalcenter.com/",
            "affiliation": "N",
            "address_1": "635 Albany St",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "02118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Grace Malvar, M.D.
• Niharika Malviya, MD
• Kacey Malz, LCSW
• Rielly Jodoin Malz, PA-C
• Vicheth Mam
• Michaela Mamary, NP
• Hosana Mamata, MD
• Katrina Marie Mamaty, PA-C
• Arif Mamdani, DMD
• Christina Mamlouk, RD

• General Practice Dentistry in Boston, MA
• Providers in Boston, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.