Individual provider Active NPI

Elizabeth G. Rooney, DMD

  • Dentist
  • Boston, MA
National Provider Identifier
1417073586
Registry record updated Sep 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
21316 Issued in MA
Practice address
451 D St
Suite 200
Boston, MA 02210-1950
Phone
(617) 737-6453
NPI assigned
Mar 21, 2007
Last updated
Sep 23, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 21316 MA Primary

Addresses

Primary practice location

451 D St
Suite 200
Boston, MA 02210-1950

Mailing address

799 E Broadway
Apt #3
South Boston, MA 02127-2346
Phone (917) 608-8055

Other identifiers 1

IdentifierTypeStateIssuer
02117559MedicaidNY

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
21316MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Seaport Dental Associates, LLC Past Accepting new patients
Seaport Dental Associates LLC Dentist Past Accepting new patients

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, 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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190505600000",
    "number": "1417073586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 E BROADWAY",
            "address_2": "APT #3",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272346",
            "telephone_number": "917-608-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 D ST",
            "address_2": "SUITE 200",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022101950",
            "telephone_number": "617-737-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROONEY",
        "first_name": "ELIZABETH",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "21316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02117559",
            "state": "NY"
        }
    ],
    "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 Sep 23, 2007; 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.