Individual provider Active NPI

Caitlin Ann Coleman, DMD

  • Dentist
  • Dorchester, MA
National Provider Identifier
1396186243
Registry record updated Jul 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DL11923 Issued in MA
Practice address
637 Washington St
Dental
Dorchester, MA 02124-3510
Phone
(617) 825-9660
Fax
(617) 288-7898
NPI assigned
Jul 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DL11923 MA Primary

Addresses

Primary practice location

637 Washington St
Dental
Dorchester, MA 02124-3510

Mailing address

637 Washington St
Dental
Dorchester, MA 02124-3510
Phone (617) 825-9660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190909001006 MA Practitioner - Dentist 7719277144 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DL11923MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Health Services Inc CurrentSince Jul 22, 2019 Accepting new patients
Harbor Health Services, Inc. CurrentSince Jul 22, 2019 Accepting new patients

Locations

250 Mount Vernon St
Dorchester, MA 02125
Phone (617) 288-1140

1135 Morton St
Mattapan, MA 02126
Phone (617) 533-2300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1396186243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 WASHINGTON ST",
            "address_2": "DENTAL",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021243510",
            "telephone_number": "617-825-9660",
            "fax_number": "617-288-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 WASHINGTON ST",
            "address_2": "DENTAL",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021243510",
            "telephone_number": "617-825-9660",
            "fax_number": "617-288-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "CAITLIN",
        "middle_name": "ANN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-08",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DL11923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

Verify at the official NPI Registry.