Individual provider Active NPI

Paul Kalish, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Boston, MA
National Provider Identifier
1467892513
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN1856302 Issued in MA
Practice address
1 Kneeland St
Dept. Oral and Maxillofacial Surgery, 5TH Floor
Boston, MA 02111-1527
Phone
(617) 636-6516
NPI assigned
Jul 2, 2013
Last updated
Mar 28, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN1856302 MA Primary

Addresses

Primary practice location

1 Kneeland St
Dept. Oral and Maxillofacial Surgery, 5TH Floor
Boston, MA 02111-1527

Mailing address

33 Bartlett St
Ste 405
Lowell, MA 01852-1318
Phone (978) 458-1264

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
I20190313001579 MA Practitioner - Dentist 3375816341 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Tufts University School of Dental Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeffrey C. Sacks DMD Ms PCGroup PAC ID 7517014673, 3 clinicians
Chestnut Hill Oral Surgery LLCGroup PAC ID 9739654500, 3 clinicians

Practice addresses (Care Compare)

200 Boylston St
Suite 305
Chestnut Hill, MA 02467-2008
Phone (617) 731-8888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1856302MAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Lowell Oral Surgery Associates, Inc Oral and Maxillofacial Surgery CurrentSince Apr 1, 2019 Accepting new patients
Chestnut Hill Oral Surgery LLC Oral and Maxillofacial Surgery CurrentSince Oct 21, 2025 Accepting new patients
Jeffrey C. Sacks DMD Ms PC Oral and Maxillofacial Surgery CurrentSince Oct 4, 2021 Accepting new patients
Lowell Oral Surgery Associates, Inc CurrentSince Apr 1, 2019 Accepting new patients

Locations

200 Boylston St
Ste 305
Chestnut Hill, MA 02467
Phone (617) 527-6669

33 Bartlett St
Ste 405
Lowell, MA 01852
Phone (508) 458-1264

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1467892513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 BARTLETT ST",
            "address_2": "STE 405",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018521318",
            "telephone_number": "978-458-1264",
            "fax_number": "978-458-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST",
            "address_2": "DEPT. ORAL AND MAXILLOFACIAL SURGERY, 5TH FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-6516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALISH",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-02",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "DN1856302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.