Active NPI
Jacquelyn Chou
- Endodontics
- Cambridge, MA
National Provider Identifier
1497311260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DN1858309
- Practice address
- 114 Mount Auburn St
Cambridge, MA 02138-5775 - Phone
- (617) 432-1434
- NPI assigned
- May 16, 2019
- Last updated
- Aug 16, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DN1858309 | MA | Primary |
Addresses
Primary practice location
114 Mount Auburn St
Cambridge, MA 02138-5775
Mailing address
802 Constitution Ave
Littleton, MA 01460-1137
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190912001135 | MA | Order and Referring Only - Dentist | 6608105820 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN1858309 | MA | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zwell, P.C. | General Practice | 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, 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": "1557964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723766400000",
"number": "1497311260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 CONSTITUTION AVE",
"city": "LITTLETON",
"state": "MA",
"postal_code": "014601137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 MOUNT AUBURN ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021385775",
"telephone_number": "617-432-1434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHOU",
"first_name": "JACQUELYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-16",
"last_updated": "2024-08-16",
"certification_date": "2024-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MA",
"license": "DN1858309",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; 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.