Active NPI
Pablo Duluc Vega, DDS, CAGS
- Endodontics
- Boston, MA
National Provider Identifier
1639467780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DN20783
- Practice address
- 100 E Newton St FL 7
Boston, MA 02118-2308 - Phone
- (617) 638-4636
- NPI assigned
- Jul 11, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DN20783 | FL | Primary |
| General Practice Dentistry | 1223G0001X | DL11318 | MA |
Addresses
Primary practice location
100 E Newton St FL 7
Boston, MA 02118-2308
Mailing address
100 E Newton St FL 7
Boston, MA 02118-2308
Phone (617) 638-4636
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160411002087 | FL | Order and Referring Only - Other (Physician) | 4688972458 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN20783 | FL | MD | Endodontist |
| DL11318 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439424000000",
"number": "1639467780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 E NEWTON ST FL 7",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182308",
"telephone_number": "617-638-4636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E NEWTON ST FL 7",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182308",
"telephone_number": "617-638-4636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DULUC VEGA",
"first_name": "PABLO",
"name_prefix": "Dr.",
"credential": "DDS, CAGS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-11",
"last_updated": "2015-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "FL",
"license": "DN20783",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "DL11318",
"primary": false
}
],
"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 Aug 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.