Individual provider Active NPI

Luca Gobbato, D.D.S.

  • Periodontics
  • Boston, MA
National Provider Identifier
1801035241
Registry record updated Feb 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
10499 Issued in MA
Practice address
One Kneeland St.
Room 250
Boston, MA 02111
Phone
(617) 636-6531
Fax
(617) 636-0911
NPI assigned
Feb 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 10499 MA Primary

Addresses

Primary practice location

One Kneeland St.
Room 250
Boston, MA 02111

Mailing address

151 Tremont St.
Apt 19L
Boston, MA 02111
Phone (617) 510-9274

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
10499MAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234137600000",
    "number": "1801035241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 TREMONT ST.",
            "address_2": "APT 19L",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02111",
            "telephone_number": "617-510-9274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE KNEELAND ST.",
            "address_2": "ROOM 250",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02111",
            "telephone_number": "617-636-6531",
            "fax_number": "617-636-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBBATO",
        "first_name": "LUCA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-09",
        "last_updated": "2009-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "10499",
            "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 Feb 9, 2009; 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.