NPIMap

Organization Active NPI

Arch St Dental Corp

  • General Practice Dentistry
  • Boston, MA
National Provider Identifier
1801208715
Registry record updated May 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21211 Issued in MA
Legal business name
ARCH ST DENTAL CORP
Practice address
103 Arch St
Boston, MA 02110-1102
Phone
(617) 338-7778
Fax
(617) 338-7779
NPI assigned
May 27, 2014
Last updated
May 27, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2014

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

Authorized official

Name
Ekatrina Mamulashvili, D.M.D
Title
Owner
Phone
(617) 338-7778

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 21211 MA Primary

Addresses

Primary practice location

103 Arch St
Boston, MA 02110-1102

Mailing address

103 Arch St
Boston, MA 02110-1102
Phone (617) 338-7778

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401148800000",
    "number": "1801208715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 ARCH ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021101102",
            "telephone_number": "617-338-7778",
            "fax_number": "617-338-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 ARCH ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021101102",
            "telephone_number": "617-338-7778",
            "fax_number": "617-338-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCH ST DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-27",
        "last_updated": "2014-05-27",
        "status": "A",
        "authorized_official_last_name": "MAMULASHVILI",
        "authorized_official_first_name": "EKATRINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-338-7778",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21211",
            "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 May 27, 2014; 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.