NPIMap

Organization Active NPI

South Boston Dental Associates

  • Dental Clinic/Center
  • South Boston, MA
National Provider Identifier
1356563316
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SOUTH BOSTON DENTAL ASSOCIATES
Practice address
29 Farragut Rd
South Boston, MA 02127-1714
Phone
(617) 268-1030
NPI assigned
May 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Philip Barber, M.D.
Title
Partner
Phone
(617) 268-1030

Specialties & licenses 1

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

Addresses

Primary practice location

29 Farragut Rd
South Boston, MA 02127-1714

Mailing address

29 Farragut Rd
South Boston, MA 02127-1714
Phone (617) 268-1030

Other identifiers 1

IdentifierTypeStateIssuer
X10143OtherBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

29 Farragut Rd
South Boston, MA 02127
Phone (617) 268-1030

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356563316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 FARRAGUT RD",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021271714",
            "telephone_number": "617-268-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 FARRAGUT RD",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021271714",
            "telephone_number": "617-268-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BOSTON DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARBER",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "617-268-1030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "X10143",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.