Individual provider Active NPI

Jessica Michelle Latimer, DDS

  • Dentist
  • Boston, MA
National Provider Identifier
1760078307
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1858880 Issued in MA
Practice address
188 Longwood Ave
Boston, MA 02115-5819
Phone
(617) 432-1434
NPI assigned
Dec 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE61086046 WA
Dentist 122300000X DN1858880 MA Primary

Addresses

Primary practice location

188 Longwood Ave
Boston, MA 02115-5819

Mailing address

217 Kent St Apt 25
Brookline, MA 02446-5426
Phone (509) 714-9002

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

LicenseStateTypeSpecialty
DN1858880MAMDDentist
DE61086046WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1760078307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 KENT ST APT 25",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465426",
            "telephone_number": "509-714-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155819",
            "telephone_number": "617-432-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATIMER",
        "first_name": "JESSICA",
        "middle_name": "MICHELLE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-17",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61086046",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1858880",
            "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 Aug 18, 2021; 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.