Virtudent Ma LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

VIRTUDENT MA LLC

Practice address

21 Drydock Ave. 6TH Floor
C/O Masschallenge
Boston, MA 02210

Phone

(617) 863-4569

NPI assigned

Apr 6, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Hitesh Gulab Tolani, DMD

Title

Ceo

Phone

(617) 863-4569

Specialties & licenses 7

Addresses

Locations

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488412800000",
    "number": "1548655541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 DRYDOCK AVE",
            "address_2": "STE 610",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022102384",
            "telephone_number": "617-863-4569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 DRYDOCK AVE. 6TH FLOOR",
            "address_2": "C/O MASSCHALLENGE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02210",
            "telephone_number": "617-863-4569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRTUDENT MA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-06",
        "last_updated": "2017-03-02",
        "status": "A",
        "authorized_official_last_name": "TOLANI",
        "authorized_official_first_name": "HITESH",
        "authorized_official_middle_name": "GULAB",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-863-4569",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "125J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "125K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Dental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Boston, MA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; 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.