Individual provider Active NPI

Kushal G Zinzuvadia, DMD

  • Dentist
  • Boston, MA
National Provider Identifier
1811462732
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1858162 Issued in MA
Practice address
162 Saint Botolph St Apt 10
Boston, MA 02115-5118
Phone
(857) 272-5494
NPI assigned
Oct 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1858162 MA Primary

Addresses

Primary practice location

162 Saint Botolph St Apt 10
Boston, MA 02115-5118

Mailing address

162 Saint Botolph St Apt 10
Boston, MA 02115-5118
Phone (857) 272-5494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190429000595 MA Order and Referring Only - DentistPractitioner - Dentist 5496097248

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1858162MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1538870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1811462732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 SAINT BOTOLPH ST APT 10",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155118",
            "telephone_number": "857-272-5494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 SAINT BOTOLPH ST APT 10",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155118",
            "telephone_number": "857-272-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZINZUVADIA",
        "first_name": "KUSHAL",
        "middle_name": "G",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-07",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1858162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.