Ban Nacy, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02512800 Issued in NJ

Practice address

55 Fruit St
1201 Warren
Boston, MA 02114-2621

Phone

(617) 724-0413

Fax

(617) 726-2814

NPI assigned

Sep 20, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ban Farid Nacy Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Detroit Dental Spa PLLC

  • Dental Clinic/Center
  • Detroit, MI
  • NPI 1366155202
  NPD Authorized official

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375488000000",
    "number": "1447501267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "1201 WARREN",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-724-0413",
            "fax_number": "617-726-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "1201 WARREN",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-724-0413",
            "fax_number": "617-726-2814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACY",
        "first_name": "BAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-20",
        "last_updated": "2013-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02512800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BAN",
            "last_name": "NACY",
            "middle_name": "FARID",
            "credential": "D.D.S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laura Annunziata Naccarato, MD
• Lisa B Nachtigall, MD
• Jaimee Nachwalter
• Thomas Richard Nackel, RPH
• Margaret E Naclerio
• Diane Susan Naczas, MSPT
• John Nadai, MD
• Nicki Naddaf, MD
• Kari C Nadeau, M.D., PH.D.
• Nicole Nadeau, M.D.

• General Practice Dentistry in Boston, MA
• Providers in Boston, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.