Individual provider Active NPI

Kelsey Alice Bjornson, DMD

  • Dentist
  • Boston, MA
National Provider Identifier
1528704400
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DL18400 Issued in MA
Practice address
1 Kneeland St
Boston, MA 02111-1527
Phone
(617) 636-6828
NPI assigned
May 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DL18400 MA Primary

Addresses

Primary practice location

1 Kneeland St
Boston, MA 02111-1527

Mailing address

1 Kneeland St FL 3
Boston, MA 02111-1527

Other practice location 1

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

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
DL18400MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1528704400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST FL 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-6828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Washington St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021111552",
            "country_code": "US",
            "telephone_number": "617-636-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BJORNSON",
        "first_name": "KELSEY",
        "middle_name": "ALICE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "DL18400",
            "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 Jul 7, 2022; 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.