Active NPI
Raju Gandhi
- Dentist
- Boston, MA
National Provider Identifier
1659071397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN10000214
- Practice address
- 635 Albany St
Boston, MA 02118-3550 - Phone
- (603) 732-3704
- NPI assigned
- Mar 9, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 | DN10000214 | MA | Primary |
Addresses
Primary practice location
635 Albany St
Boston, MA 02118-3550
Mailing address
8 Misty Meadow Way
Mechanicville, NY 12118-3651
Phone (603) 732-3704
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Dentist
- Education
- Boston Univ Goldman School of Dental Medicine, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
637 Washington St
Dorchester, MA 02124-3510
PO Box
Suite 248
Bristol, NH 03222
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN10000214 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720396800000",
"number": "1659071397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 MISTY MEADOW WAY",
"city": "MECHANICVILLE",
"state": "NY",
"postal_code": "121183651",
"telephone_number": "603-732-3704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "635 ALBANY ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021183550",
"telephone_number": "603-732-3704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANDHI",
"first_name": "RAJU",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-03-09",
"last_updated": "2024-07-08",
"certification_date": "2024-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN10000214",
"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 Jul 8, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.