Sri Dental Arts PC

Primary specialty

DentistTaxonomy code 122300000X

License

DN21334 Issued in MA

Legal business name

SRI DENTAL ARTS PC

Practice address

1811 Centre St
West Roxbury Dental Arts
W Roxbury, MA 02132

Phone

(617) 323-0800

NPI assigned

Aug 10, 2015

Last updated

Aug 10, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Srismitha Modem

Title

DMD

Phone

(617) 784-3133

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439164800000",
    "number": "1467838797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 CENTRE ST",
            "address_2": "WEST ROXBURY DENTAL ARTS",
            "city": "W ROXBURY",
            "state": "MA",
            "postal_code": "02132",
            "telephone_number": "617-323-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 CENTRE ST",
            "address_2": "WEST ROXBURY DENTAL ARTS",
            "city": "W ROXBURY",
            "state": "MA",
            "postal_code": "02132",
            "telephone_number": "617-323-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRI DENTAL ARTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-10",
        "last_updated": "2015-08-10",
        "status": "A",
        "authorized_official_last_name": "MODEM",
        "authorized_official_first_name": "SRISMITHA",
        "authorized_official_title_or_position": "DMD",
        "authorized_official_telephone_number": "617-784-3133",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN21334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sascha S Beutler, M.D.
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• Michael James Butera, CRNA
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• Dentist in W Roxbury, MA
• Providers in W Roxbury, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; 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.