Individual provider Active NPI

Mariam Malament, DMD, MSC, PHD

  • Dentist
  • Boston, MA
National Provider Identifier
1710385653
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1859500 Issued in MA
Practice address
1 Kneeland St.
Tufts University School of Dental Medicine
Boston, MA 02111
Phone
(617) 636-2436
Fax
(617) 636-6583
NPI assigned
Dec 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DL12259 MA
Dentist 122300000X DN1859500 MA Primary

Addresses

Primary practice location

1 Kneeland St.
Tufts University School of Dental Medicine
Boston, MA 02111

Mailing address

50 Staniford St FL 5
Boston Prosthodontics
Boston, MA 02114-2517
Phone (617) 523-5451

Other practice location 1

Boston Prosthodontics
50 Staniford St Fl 5
Boston, MA 02114
Phone (617) 523-5451

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
DL12259MAMDDentist
DN1859500MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1710385653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 STANIFORD ST FL 5",
            "address_2": "BOSTON PROSTHODONTICS",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142517",
            "telephone_number": "617-523-5451",
            "fax_number": "617-636-6583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST.",
            "address_2": "TUFTS UNIVERSITY SCHOOL OF DENTAL MEDICINE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02111",
            "telephone_number": "617-636-2436",
            "fax_number": "617-636-6583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Boston Prosthodontics",
            "address_2": "50 Staniford St Fl 5",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02114",
            "country_code": "US",
            "telephone_number": "617-523-5451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALAMENT",
        "first_name": "MARIAM",
        "credential": "DMD, MSC, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-09",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DL12259",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1859500",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 22, 2023; 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.