Active NPI
Douglas Ian Storch, DMD
- Dentist
- Cambridge, MA
National Provider Identifier
1689876336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN17936
- Practice address
- 119 Windsor St
1St Floor
Cambridge, MA 02139-3647 - Phone
- (352) 514-9217
- NPI assigned
- Jun 4, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN17936 | FL | Primary |
Addresses
Primary practice location
119 Windsor St
1St Floor
Cambridge, MA 02139-3647
Mailing address
140 Boylston St
Apt 10
Boston, MA 02116-4632
Phone (352) 514-9217
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 |
|---|---|---|---|---|
| I20151201000354 | FL | Order and Referring Only - Other (Physician) | 4789984568 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN17936 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689876336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 BOYLSTON ST",
"address_2": "APT 10",
"city": "BOSTON",
"state": "MA",
"postal_code": "021164632",
"telephone_number": "352-514-9217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 WINDSOR ST",
"address_2": "1ST FLOOR",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021393647",
"telephone_number": "352-514-9217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STORCH",
"first_name": "DOUGLAS",
"middle_name": "IAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN17936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.