Active NPI
Mary Kyuregyan
- General Practice Dentistry
- Waltham, MA
National Provider Identifier
1841095270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN10001042
- Practice address
- 204 Clocktower Dr Unit 6113
Waltham, MA 02452-7884 - Phone
- (781) 652-1275
- NPI assigned
- Feb 18, 2025
- Last updated
- Sep 16, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN10001042 | MA | Primary |
Addresses
Primary practice location
204 Clocktower Dr Unit 6113
Waltham, MA 02452-7884
Mailing address
204 Clocktower Dr Unit 6113
Waltham, MA 02452-7884
Phone (781) 652-1275
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN10001042 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757980800000",
"number": "1841095270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 CLOCKTOWER DR UNIT 6113",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024527884",
"telephone_number": "781-652-1275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 CLOCKTOWER DR UNIT 6113",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024527884",
"telephone_number": "781-652-1275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KYUREGYAN",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-02-18",
"last_updated": "2025-09-16",
"certification_date": "2025-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "DN10001042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.