Individual provider Active NPI

Rebecca Gollub Gottesman, DMD

  • Dentist
  • Chestnut Hill, MA
National Provider Identifier
1376160192
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS042694 Issued in PA
Practice address
300 Boylston St Ste 202
Chestnut Hill, MA 02467-1977
Phone
(617) 232-7100
NPI assigned
Jun 26, 2020
Last updated
Sep 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS042694 PA Primary
Pediatric Dentistry 1223P0221X DS042694 PA

Addresses

Primary practice location

300 Boylston St Ste 202
Chestnut Hill, MA 02467-1977

Mailing address

300 Boylston St Ste 202
Chestnut Hill, MA 02467-1977

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

LicenseStateTypeSpecialty
DS042694PAMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1376160192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BOYLSTON ST STE 202",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024671977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BOYLSTON ST STE 202",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024671977",
            "telephone_number": "617-232-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTESMAN",
        "first_name": "REBECCA",
        "middle_name": "GOLLUB",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS042694",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS042694",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestnut Hill, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; 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.