Individual provider Active NPI

Michael Chen, DMD

  • Periodontics
  • Boston, MA
National Provider Identifier
1841972148
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DN10000073 Issued in MA
Practice address
188 Longwood Ave
Boston, MA 02115-5888
Phone
(617) 432-1434
NPI assigned
Aug 4, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X DN10000073 MA Primary

Addresses

Primary practice location

188 Longwood Ave
Boston, MA 02115-5888

Mailing address

251 Heath St Apt 304
Boston, MA 02130-1168
Phone (413) 210-7639

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
DN10000073MAMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1691107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1841972148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 HEATH ST APT 304",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021301168",
            "telephone_number": "413-210-7639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155888",
            "telephone_number": "617-432-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-04",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "DN10000073",
            "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 Jul 16, 2024; 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.