Individual provider Active NPI

Ummesalma Dhariwala

  • General Practice Dentistry
  • Northborough, MA
National Provider Identifier
1689938565
Registry record updated Feb 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1856049 Issued in MA
Practice address
25 Dunia LN # 25
Northborough, MA 01532-2460
Phone
(732) 318-0528
NPI assigned
Jun 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2017

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 DN1856049 MA Primary
Pediatric Dentistry 1223P0221X DN1856049 MA

Addresses

Primary practice location

25 Dunia LN # 25
Northborough, MA 01532-2460

Mailing address

25 Dunia LN # 25
Northborough, MA 01532-2460
Phone (732) 318-0528

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
I20161107000104 MA Order and Referring Only - DentistPractitioner - Dentist 3870871221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1856049MAMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486857600000",
    "number": "1689938565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 DUNIA LN # 25",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015322460",
            "telephone_number": "732-318-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 DUNIA LN # 25",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015322460",
            "telephone_number": "732-318-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHARIWALA",
        "first_name": "UMMESALMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-26",
        "last_updated": "2017-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1856049",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "DN1856049",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northborough, MA

Sources for this page

Verify at the official NPI Registry.