Individual provider Active NPI

Yu Chia Edward Kuo, DDS

  • Dentist
  • Boston, MA
National Provider Identifier
1841877461
Registry record updated Oct 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1859730 Issued in MA
Practice address
1 Kneeland St
Boston, MA 02111-1527
Phone
(425) 633-4824
NPI assigned
Mar 28, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1859730 MA Primary
General Practice Dentistry 1223G0001X DE61178805 WA
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1 Kneeland St
Boston, MA 02111-1527

Mailing address

50 Malden St Apt 411
Boston, MA 02118-2891
Phone (425) 633-4824

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
I20240228003558 MA Order and Referring Only - DentistPractitioner - Dentist 4688019789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE61178805WAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1616889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697328000000",
    "number": "1841877461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MALDEN ST APT 411",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182891",
            "telephone_number": "425-633-4824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "425-633-4824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUO",
        "first_name": "YU CHIA",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-28",
        "last_updated": "2023-10-15",
        "certification_date": "2023-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1859730",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61178805",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.