Individual provider Active NPI

Anne-Marie Barussaud, D.M.D.

  • Dentist
  • Boston, MA
National Provider Identifier
1508066291
Registry record updated Sep 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
LL9316 Issued in MA
Practice address
100 E Newton St RM 202B
Boston, MA 02118-2308
Phone
(617) 638-4748
NPI assigned
Jul 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X LL9316 MA Primary

Addresses

Primary practice location

100 E Newton St RM 202B
Boston, MA 02118-2308

Mailing address

100 E Newton St RM 202B
Boston, MA 02118-2308
Phone (617) 638-4748

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

State licenses

LicenseStateTypeSpecialty
LL9316MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189382400000",
    "number": "1508066291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E NEWTON ST RM 202B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182308",
            "telephone_number": "617-638-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E NEWTON ST RM 202B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182308",
            "telephone_number": "617-638-4748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARUSSAUD",
        "first_name": "ANNE-MARIE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2007-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "LL9316",
            "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 Sep 10, 2007; 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.