Individual provider Active NPI

John Ficarelli, D.M.D.

  • Pediatric Dentistry
  • Brookline, MA
National Provider Identifier
1407817141
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
12246 Issued in MA
Practice address
1684 Beacon St
Brookline, MA 02445-2101
Phone
(617) 232-7100
Fax
(617) 232-4191
NPI assigned
Mar 31, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 12246 MA Primary

Addresses

Primary practice location

1684 Beacon St
Brookline, MA 02445-2101

Mailing address

1684 Beacon St
Brookline, MA 02445-2101
Phone (617) 232-7100

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
I20150326001671 MA Order and Referring Only - DentistPractitioner - Dentist 7911224167

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12246MAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Dental Associates of Brookline, PC Pediatric Dentistry Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1407817141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1684 BEACON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024452101",
            "telephone_number": "617-232-7100",
            "fax_number": "617-232-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1684 BEACON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024452101",
            "telephone_number": "617-232-7100",
            "fax_number": "617-232-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FICARELLI",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "12246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.