NPIMap

Organization Active NPI

Trustees of Tufts College

Doing business as Tufts University School of Dental Medicine

  • Dental Clinic/Center
  • Boston, MA
National Provider Identifier
1356559371
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
4105 Issued in MA
Legal business name
TRUSTEES OF TUFTS COLLEGE
Doing business as
Tufts University School of Dental Medicine
Practice address
1 Kneeland St FL 5
Boston, MA 02111-1527
Phone
(617) 636-6842
Fax
(617) 636-0309
NPI assigned
May 21, 2007
Last updated
Apr 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Authorized official

Name
Ms. Beth Ann Conant
Title
Director of Finance & Admin
Phone
(617) 636-6842

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 4105 MA Primary

Addresses

Primary practice location

1 Kneeland St FL 5
Boston, MA 02111-1527

Mailing address

1 Kneeland St FL 5
Boston, MA 02111-1527
Phone (617) 636-6842

Other identifiers 2

IdentifierTypeStateIssuer
X12142OtherMABLUE CROSS BLUE SHIELD
0264679MedicaidMA

Other names 1

  • Tufts University School of Dental Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080425000216 MA Part B Supplier - Clinic/Group Practice 3779522628 Receives reassigned benefits from 20 practitioners
2 other NPIs on this enrollment
Practice locations: Boston, MA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Tufts Univ Health23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

1 Kneeland St
Fl 15
Boston, MA 02111
Phone (617) 636-6828

1 Kneeland St
Fl 5
Boston, MA 02111
Phone (617) 636-6515

169 Holland St
Somerville, MA 02144

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745884800000",
    "number": "1356559371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST FL 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-6842",
            "fax_number": "617-636-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST FL 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-6842",
            "fax_number": "617-636-0309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUSTEES OF TUFTS COLLEGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A",
        "authorized_official_last_name": "CONANT",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE & ADMIN",
        "authorized_official_telephone_number": "617-636-6842",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MA",
            "license": "4105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "X12142",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0264679",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tufts University School of Dental Medicine",
            "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 Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.