Individual provider Active NPI

Aphrodite Tantiras

  • General Practice Dentistry
  • Allston, MA
National Provider Identifier
1558507798
Registry record updated Dec 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22341 Issued in MA
Practice address
127 Harvard Ave
Allston, MA 02134-2702
Phone
(617) 789-4200
NPI assigned
Dec 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2008

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 22341 MA Primary

Addresses

Primary practice location

127 Harvard Ave
Allston, MA 02134-2702

Mailing address

85 Brainerd Rd
Apt 309
Allston, MA 02134-4529
Phone (516) 445-1013

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
I20160506000674 MA Order and Referring Only - DentistPractitioner - Dentist 8224337605

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22341MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Allston Family Dental General Practice Past Accepting new patients
Springfield Family Dental PC PastSince Oct 9, 2022 Accepting new patients

Organizations & group practices 2

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": "1229472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229472000000",
    "number": "1558507798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 BRAINERD RD",
            "address_2": "APT 309",
            "city": "ALLSTON",
            "state": "MA",
            "postal_code": "021344529",
            "telephone_number": "516-445-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 HARVARD AVE",
            "city": "ALLSTON",
            "state": "MA",
            "postal_code": "021342702",
            "telephone_number": "617-789-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANTIRAS",
        "first_name": "APHRODITE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-17",
        "last_updated": "2008-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "22341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allston, MA

Sources for this page

Verify at the official NPI Registry.