Active NPI
Michael Jeffrey Overbeck, D.D.S.
- Dentist
- Boston, MA
National Provider Identifier
1366468878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12142
- Practice address
- 427 Commercial St
Boston, MA 02109-1027 - Phone
- (617) 223-3243
- Fax
- (617) 223-3038
- NPI assigned
- Jul 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12142 | MD | Primary |
| Dentist | 122300000X | 21771 | MA |
Addresses
Primary practice location
427 Commercial St
Boston, MA 02109-1027
Mailing address
427 Commercial St
Boston, MA 02109-1027
Phone (617) 223-3243
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12142 | MD | MD | Dentist |
| 21771 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242691200000",
"number": "1366468878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "427 COMMERCIAL ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021091027",
"telephone_number": "617-223-3243",
"fax_number": "617-223-3038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "427 COMMERCIAL ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021091027",
"telephone_number": "617-223-3243",
"fax_number": "617-223-3038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OVERBECK",
"first_name": "MICHAEL",
"middle_name": "JEFFREY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-15",
"last_updated": "2009-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "12142",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "21771",
"primary": false
}
],
"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 19, 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.