Active NPI
Shatha Subhi Al-Harthi
- Periodontics
- Boston, MA
National Provider Identifier
1699029355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DL11760
- Practice address
- 660 Washington St
23J
Boston, MA 02111-3200 - Phone
- (646) 428-4536
- NPI assigned
- Nov 2, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DL11760 | MA | Primary |
Addresses
Primary practice location
660 Washington St
23J
Boston, MA 02111-3200
Mailing address
660 Washington Street
J Archstone Buliding App#23
Boston, MA 02111
Phone (646) 428-4536
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DL11760 | Other | MA | LICENSE NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| DL11760 | MA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351814400000",
"number": "1699029355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 WASHINGTON STREET",
"address_2": "J ARCHSTONE BULIDING APP#23",
"city": "BOSTON",
"state": "MA",
"postal_code": "02111",
"telephone_number": "646-428-4536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "660 WASHINGTON ST",
"address_2": "23J",
"city": "BOSTON",
"state": "MA",
"postal_code": "021113200",
"telephone_number": "646-428-4536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AL-HARTHI",
"first_name": "SHATHA",
"middle_name": "SUBHI",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-02",
"last_updated": "2012-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MA",
"license": "DL11760",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "DL11760",
"state": "MA"
}
],
"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 Nov 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.