Active NPI
Michelle Poon
- Dentist
- Boston, MA
National Provider Identifier
1619467057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN1857912
- Practice address
- 658 Tremont St Apt 9
Boston, MA 02118 - Phone
- (857) 366-3611
- NPI assigned
- May 11, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN1857912 | MA | Primary |
Addresses
Primary practice location
658 Tremont St Apt 9
Boston, MA 02118
Mailing address
158 N Main St
Uxbridge, MA 01569-1748
Phone (508) 714-7068
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN1857912 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528329600000",
"number": "1619467057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "158 N MAIN ST",
"city": "UXBRIDGE",
"state": "MA",
"postal_code": "015691748",
"telephone_number": "508-714-7068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "658 TREMONT ST APT 9",
"city": "BOSTON",
"state": "MA",
"postal_code": "02118",
"telephone_number": "857-366-3611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POON",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-11",
"last_updated": "2018-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN1857912",
"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 Jun 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.