NPIMap

Individual provider Active NPI

Sanjeevan Virk, D.M.D.

  • Dentist
  • Somerville, MA
National Provider Identifier
1659517498
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1855058 Issued in MA
Practice address
5 Middlesex Ave
Suite 305
Somerville, MA 02145-1102
Phone
(617) 764-1781
Fax
(617) 764-5649
NPI assigned
Dec 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 57983 CA
Dentist 122300000X DN1855058 MA Primary

Addresses

Primary practice location

5 Middlesex Ave
Suite 305
Somerville, MA 02145-1102

Mailing address

PO Box 231118
Boston, MA 02123-1118
Phone (510) 789-7557

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

LicenseStateTypeSpecialty
DN1855058MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Assembly Square Family Dental General Practice 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": "1230508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1659517498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 231118",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021231118",
            "telephone_number": "510-789-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MIDDLESEX AVE",
            "address_2": "SUITE 305",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021451102",
            "telephone_number": "617-764-1781",
            "fax_number": "617-764-5649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRK",
        "first_name": "SANJEEVAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-29",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57983",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1855058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; 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.