Prashansa Gautam

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Practice address

50 S Huntington Ave
Boston, MA 02130-4713

Phone

(617) 232-9500

NPI assigned

Mar 25, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1700636651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 COLLEGE DR",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902724",
            "telephone_number": "631-624-5914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 S HUNTINGTON AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021304713",
            "telephone_number": "617-232-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 College Dr",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117902724",
            "country_code": "US",
            "telephone_number": "631-624-5914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAUTAM",
        "first_name": "PRASHANSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Elizabeth Gaudino, CERTIFIED DOULA
• Kristina Marie Gaudino, CRNA
• Sonia Gaur, MD
• Amitabh Gautam, MD
• Ayushi Gautam
• Amie Gauthier, PA-C
• Denise D Gauthier, NP
• Diane Gauthier, N.P.
• Kathy Davis Gauthier, PA-C
• Naomi Schiffman Gauthier, MD

• Dental Clinic/Center in Boston, MA
• Providers in Boston, MA by specialty
• Dental Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.