NPIMap

Organization Active NPI

Boston Dental

Doing business as Fred G. Boustany D.M.D.,PC

  • General Practice Dentistry
  • Boston, MA
National Provider Identifier
1710013172
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15733 Issued in MA
Legal business name
BOSTON DENTAL
Doing business as
Fred G. Boustany D.M.D.,PC
Practice address
36 Chauncy St
Boston, MA 02111-2209
Phone
(617) 338-5000
Fax
(617) 338-1039
NPI assigned
Feb 27, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Fred G. Boustany, DMDNPI 1568527331
Title
President
Phone
(617) 338-5000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15733 MA Primary

Addresses

Primary practice location

36 Chauncy St
Boston, MA 02111-2209

Mailing address

36 Chauncy St
Boston, MA 02111-2209
Phone (617) 338-5000

Other names 1

  • Fred G. Boustany D.M.D.,PC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710013172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 CHAUNCY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021112209",
            "telephone_number": "617-338-5000",
            "fax_number": "617-338-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 CHAUNCY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021112209",
            "telephone_number": "617-338-5000",
            "fax_number": "617-338-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOUSTANY",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-338-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "15733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fred G. Boustany D.M.D.,PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 2020; 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.