Individual provider Active NPI

Jose Gilberto Arciniegas, DDS,MPH

  • General Practice Dentistry
  • Dorchester, MA
National Provider Identifier
1649353061
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9164 Issued in MA
Practice address
636 Columbia Rd
Dorchester, MA 02125-3416
Phone
(617) 825-9839
NPI assigned
Oct 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 9164 MA Primary

Addresses

Primary practice location

636 Columbia Rd
Dorchester, MA 02125-3416

Mailing address

15 Harbor Point Blvd Apt 304
Dorchester, MA 02125-3204
Phone (617) 283-1560

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
I20160826001983 MA Order and Referring Only - DentistPractitioner - Dentist 4385939578

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9164MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Upham'S Corner Health Committee, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1161388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649353061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 HARBOR POINT BLVD APT 304",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021253204",
            "telephone_number": "617-283-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 COLUMBIA RD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021253416",
            "telephone_number": "617-825-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCINIEGAS",
        "first_name": "JOSE",
        "middle_name": "GILBERTO",
        "name_prefix": "Dr.",
        "credential": "DDS,MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "9164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

Verify at the official NPI Registry.