Organization Active NPI

My Dental East Boston

  • Dental Clinic/Center
  • East Boston, MA
National Provider Identifier
1780192393
Registry record updated Jan 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MY DENTAL EAST BOSTON
Practice address
151 Meridian St
East Boston, MA 02128-1675
Phone
(740) 215-8549
NPI assigned
Jan 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2018

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

Authorized official

Name
Srinivas Desaneedi, DMD
Title
Treasure
Phone
(740) 215-8549

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

151 Meridian St
East Boston, MA 02128-1675

Mailing address

20 Balancing Rock Rd
Canton, MA 02021-4230

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1516147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516147200000",
    "number": "1780192393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 BALANCING ROCK RD",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020214230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 MERIDIAN ST",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021281675",
            "telephone_number": "740-215-8549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY DENTAL EAST BOSTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-17",
        "last_updated": "2018-01-17",
        "status": "A",
        "authorized_official_last_name": "DESANEEDI",
        "authorized_official_first_name": "SRINIVAS",
        "authorized_official_title_or_position": "TREASURE",
        "authorized_official_telephone_number": "740-215-8549",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2018; 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.