Active NPI
Casey Boyea Cook, D.M.D.
- General Practice Dentistry
- Somerville, MA
National Provider Identifier
1861527830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 19512
- Practice address
- 51 Holland St
Somerville, MA 02144-2731 - Phone
- (617) 623-6767
- Fax
- (617) 666-3033
- NPI assigned
- Feb 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 19512 | MA | Primary |
Addresses
Primary practice location
51 Holland St
Somerville, MA 02144-2731
Mailing address
51 Holland St
Somerville, MA 02144-2731
Phone (617) 623-6767
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| X11156 | Other | MA | BLUE CROSS BLUE SHIELD |
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 |
|---|---|---|---|
| 19512 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861527830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 HOLLAND ST",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021442731",
"telephone_number": "617-623-6767",
"fax_number": "617-666-3033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 HOLLAND ST",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021442731",
"telephone_number": "617-623-6767",
"fax_number": "617-666-3033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "CASEY",
"middle_name": "BOYEA",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "19512",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "X11156",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Somerville, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.