Sandrine Marie Couldwell, DDS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN1859122 Issued in MA

Practice address

151 Merrimac St Ste 100
Boston, MA 02114-4717

Phone

(617) 982-2233

NPI assigned

May 22, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1871150060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 QUINCY SHORE DR UNIT 112",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021712943",
            "telephone_number": "801-560-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 MERRIMAC ST STE 100",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021144717",
            "telephone_number": "617-982-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULDWELL",
        "first_name": "SANDRINE",
        "middle_name": "MARIE",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-22",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1859122",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "DN1859122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY OF UTAH SCHOOL OF DENTISTRY UID",
            "identifier": "0334339",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY OF NORTH CAROLINA UID",
            "identifier": "252534",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Coughlin, DO
• Michelle Lee Coughlin, DPT
• Nancy L Coughlin, NP
• Sarah Beth Coughlin, LICSW
• Stephen M Coughlin, LMHC
• Lily C. Coulon, PA
• Ryanne Coulson, PA
• David L. Coulter, M.D.
• Jean Valery Charles Emile Coumans, MD
• Daniel Counihan, MD

• Periodontics in Boston, MA
• Providers in Boston, MA by specialty
• Periodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.

Verify at the official NPI Registry.