Active NPI
Stephen Colchamiro, DMD
- Dentist
- Jamaica Plain, MA
National Provider Identifier
1740230259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 11321
- Practice address
- 3297 Washington Street
Brookside Community Health Center
Jamaica Plain, MA 02130 - Phone
- (617) 522-4700
- NPI assigned
- May 12, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 11321 | MA | Primary |
Addresses
Primary practice location
3297 Washington Street
Brookside Community Health Center
Jamaica Plain, MA 02130
Mailing address
3297 Washington Street
Brookside Community Health Center
Jamaica Plain, MA 02130
Phone (617) 522-4700
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369180800000",
"number": "1740230259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3297 WASHINGTON STREET",
"address_2": "BROOKSIDE COMMUNITY HEALTH CENTER",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "02130",
"telephone_number": "617-522-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3297 WASHINGTON STREET",
"address_2": "BROOKSIDE COMMUNITY HEALTH CENTER",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "02130",
"telephone_number": "617-522-4700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLCHAMIRO",
"first_name": "STEPHEN",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-12",
"last_updated": "2013-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "11321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica Plain, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.