Active NPI
Osama Serraj
- Dentist
- Boston, MA
National Provider Identifier
1396525796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DL15894
- Practice address
- 635 Albany St
Boston, MA 02118-3550 - Phone
- (617) 358-8300
- NPI assigned
- Oct 3, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DL15894 | MA | Primary |
Addresses
Primary practice location
635 Albany St
Boston, MA 02118-3550
Mailing address
15 Parkside PL Apt 202
Revere, MA 02151-1150
Phone (220) 246-4850
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 |
|---|---|---|---|
| DL15894 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696291200000",
"number": "1396525796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 PARKSIDE PL APT 202",
"city": "REVERE",
"state": "MA",
"postal_code": "021511150",
"telephone_number": "220-246-4850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "635 ALBANY ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021183550",
"telephone_number": "617-358-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERRAJ",
"first_name": "OSAMA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-10-03",
"last_updated": "2023-10-03",
"certification_date": "2023-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DL15894",
"primary": true
}
],
"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 Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.