Individual provider Active NPI

Alec H. Jaret, DMD

  • Dentist
  • Wellesley, MA
National Provider Identifier
1427064773
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
15142 Issued in MA
Practice address
888 Worcester St
Suite 130
Wellesley, MA 02482-3744
Phone
(617) 964-6681
Fax
(339) 686-2561
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 15142 MA Primary
Dentist 122300000X DS029317L PA
Dentist 122300000X 22D101941400 NJ
Dentist 122300000X 0022019 TX
Dentist 122300000X 4823-015 WI

Addresses

Primary practice location

888 Worcester St
Suite 130
Wellesley, MA 02482-3744

Mailing address

888 Worcester St
Suite 130
Wellesley, MA 02482-3744
Phone (617) 964-6681

Other identifiers 4

IdentifierTypeStateIssuer
0265209MedicaidMA
170557601MedicaidTX
0015233930004MedicaidPA
33735500MedicaidWI

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
I20150518001555 MA Order and Referring Only - DentistPractitioner - Dentist 5799738217

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15142MAMDDentist
22D101941400NJMDDentist
DS029317LPAMDDentist
0022019TXMDDentist
4823-015WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1427064773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 WORCESTER ST",
            "address_2": "SUITE 130",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024823744",
            "telephone_number": "617-964-6681",
            "fax_number": "339-686-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 WORCESTER ST",
            "address_2": "SUITE 130",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024823744",
            "telephone_number": "617-964-6681",
            "fax_number": "339-686-2561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARET",
        "first_name": "ALEC",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "15142",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS029317L",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22D101941400",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "0022019",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "4823-015",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0265209",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170557601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015233930004",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33735500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

Verify at the official NPI Registry.