NPIMap

Organization Active NPI

Ak Dental Practice PC

  • Dentist
  • Cambridge, MA
National Provider Identifier
1568680205
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18827 Issued in MA
Legal business name
AK DENTAL PRACTICE PC
Practice address
20 Hurley St
Cambridge, MA 02141-2111
Phone
(617) 491-1403
Fax
(617) 491-5648
NPI assigned
Apr 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mustafa Ahed Khalil, DMDNPI 1154474922
Title
Owner
Phone
(617) 491-1403

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 18827 MA Primary

Addresses

Primary practice location

20 Hurley St
Cambridge, MA 02141-2111

Mailing address

20 Hurley St
Cambridge, MA 02141-2111
Phone (617) 491-1403

Other names 1

  • GOLDSTONE,KHALIL & ASSC Doing business as

National Provider Directory

National Provider Directory

Locations

20 Hurley St
Cambridge, MA 02141
Phone (617) 491-1403

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568680205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HURLEY ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021412111",
            "telephone_number": "617-491-1403",
            "fax_number": "617-491-5648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HURLEY ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021412111",
            "telephone_number": "617-491-1403",
            "fax_number": "617-491-5648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AK DENTAL PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KHALIL",
        "authorized_official_first_name": "MUSTAFA",
        "authorized_official_middle_name": "AHED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-491-1403",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "18827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GOLDSTONE,KHALIL & ASSC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 22, 2020; 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.