Active NPI
Coco Jeong En Roening, DDS
- Denturist
- Boston, MA
National Provider Identifier
1447822671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Denturist
- License
- DL100814
- Practice address
- 635 Albany St
Boston, MA 02118-3550 - Phone
- (617) 358-8300
- NPI assigned
- Jul 16, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Denturist | 122400000X | DL100814 | MA | Primary |
Addresses
Primary practice location
635 Albany St
Boston, MA 02118-3550
Mailing address
725 Harrison Ave Unit E402
Boston, MA 02118-2758
Phone (415) 542-6632
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241125000099 | NC | Order and Referring Only - Dentist | 0941735278 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DL100814 | MA | MD | Denturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756771200000",
"number": "1447822671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 HARRISON AVE UNIT E402",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182758",
"telephone_number": "415-542-6632"
},
{
"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": "ROENING",
"first_name": "COCO",
"middle_name": "JEONG EN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-16",
"last_updated": "2025-09-02",
"certification_date": "2025-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "122400000X",
"taxonomy_group": "",
"desc": "Denturist",
"state": "MA",
"license": "DL100814",
"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 Sep 2, 2025; 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.