Active NPI
Daniel Boateng
- Pediatric Dentistry
- Providence, RI
National Provider Identifier
1740920057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DS044467
- Practice address
- 21 Peace St
Providence, RI 02907-1510 - Phone
- (401) 456-4461
- NPI assigned
- Apr 1, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | RI | ||
| Pediatric Dentistry | 1223P0221X | DS044467 | PA | Primary |
Addresses
Primary practice location
21 Peace St
Providence, RI 02907-1510
Mailing address
1013 Burnet Ave
Union, NJ 07083-5610
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 |
|---|---|---|---|
| DS044467 | PA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718928000000",
"number": "1740920057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1013 BURNET AVE",
"city": "UNION",
"state": "NJ",
"postal_code": "070835610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 PEACE ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029071510",
"telephone_number": "401-456-4461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOATENG",
"first_name": "DANIEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-01",
"last_updated": "2024-06-21",
"certification_date": "2024-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "RI",
"license": null,
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "PA",
"license": "DS044467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.