Individual provider Active NPI

Guilherme Bonecker Valverde, DDS, MS, PHD

  • Prosthodontics
  • Boston, MA
National Provider Identifier
1467713347
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DF10753 Issued in MA
Practice address
1 Kneeland St
Tufs School of Dental Medicine- Dept. of Prosthodontics
Boston, MA 02111-1527
Phone
(617) 636-3491
NPI assigned
Jun 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X DF10753 MA Primary

Addresses

Primary practice location

1 Kneeland St
Tufs School of Dental Medicine- Dept. of Prosthodontics
Boston, MA 02111-1527

Mailing address

41 Park St
Apt 411
Brookline, MA 02446-6264
Phone (347) 447-4745

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
Credentials
Master of Science, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
DF10753MAMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1467713347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 PARK ST",
            "address_2": "APT 411",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024466264",
            "telephone_number": "347-447-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST",
            "address_2": "TUFS SCHOOL OF DENTAL MEDICINE- DEPT. OF PROSTHODONTICS",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALVERDE",
        "first_name": "GUILHERME",
        "middle_name": "BONECKER",
        "name_prefix": "Dr.",
        "credential": "DDS, MS, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MA",
            "license": "DF10753",
            "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 Jun 6, 2012; 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.