Individual provider Active NPI

Ema Bimbli, DMD

  • General Practice Dentistry
  • South Boston, MA
National Provider Identifier
1477567055
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21327 Issued in MA
Practice address
386 W Broadway
South Boston, MA 02127-2215
Phone
(617) 269-7500
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 21327 MA Primary

Addresses

Primary practice location

386 W Broadway
South Boston, MA 02127-2215

Mailing address

81 Thornton Rd
Chestnut Hill, MA 02467-3616
Phone (617) 269-7500

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
I20150406000955 MA Order and Referring Only - DentistPractitioner - Dentist 4587982426

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21327MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477567055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 THORNTON RD",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024673616",
            "telephone_number": "617-269-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "386 W BROADWAY",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272215",
            "telephone_number": "617-269-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIMBLI",
        "first_name": "EMA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, MA

Sources for this page

Verify at the official NPI Registry.