Active NPI
Shadi Kashani Aryanpour, DMD, MPM
- Endodontics
- Medford, MA
National Provider Identifier
1861407264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 20272
- Practice address
- 0 Governors Ave
Medford, MA 02155-3025 - Phone
- (781) 391-5100
- Fax
- (781) 391-4833
- NPI assigned
- Jul 31, 2006
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 20272 | MA | Primary |
Addresses
Primary practice location
0 Governors Ave
Medford, MA 02155-3025
Mailing address
490 Beacon St
Chestnut Hill, MA 02467-1168
Phone (617) 216-7884
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150522000837 | MA | Order and Referring Only - Oral Surgery | 1355661885 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20272 | MA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861407264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "490 BEACON ST",
"city": "CHESTNUT HILL",
"state": "MA",
"postal_code": "024671168",
"telephone_number": "617-216-7884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "0 GOVERNORS AVE",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021553025",
"telephone_number": "781-391-5100",
"fax_number": "781-391-4833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARYANPOUR",
"first_name": "SHADI",
"middle_name": "KASHANI",
"name_prefix": "Mrs.",
"credential": "DMD, MPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MA",
"license": "20272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.