Akram E Rafla, BDS, DMS

Individual provider Active NPI Periodontics · Northboro, MA

NPI 1376659607 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1376659607
Entity type
Individual (NPI type 1)
Primary specialty
Periodontics 1223P0300X
License
18260 (MA)
Practice address
Suite 102
1 East Main St
Northboro, MA 01532
Phone
(508) 393-0161
Fax
(508) 351-6900
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150602001560 MA Order and Referring Only - Other (Physician)
Practitioner - Other (Physician)
0345561411

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
18260MAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Akram E Rafla, DMD, PC Periodontics Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 18260 MA Yes

Addresses

Primary practice location

Suite 102
1 East Main St
Northboro, MA 01532

Mailing address

Suite 701
255 Park Ave
Worcester, MA 01609
Phone (508) 363-4400

Other providers in Northboro, MA

All providers in Northboro, MA · Periodontics in Massachusetts

Sources for this page

Verify at the official NPI Registry.