Alecsander Nicolas De Fabrique, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0000000000000 Issued in MD

Practice address

1 Kneeland St
Boston, MA 02111-1527

Phone

(617) 636-6828

NPI assigned

Jun 20, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1881325934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 LOMASNEY WAY APT 1411",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021141551",
            "telephone_number": "561-676-0779"
        },
        {
            "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": "617-636-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE FABRIQUE",
        "first_name": "ALECSANDER",
        "middle_name": "NICOLAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "0000000000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Filipe La Fuente De Carvalho, M.D., PH.D.
• Anna Maria Ocampo De Claro, M.D.
• Paulo De Coelho Castro, MD
• Marina De Cos Gomez, MD, MS
• Mariana De Coste Calla, MSW, LICSW
• Sarah De Ferranti, MD
• My-Hanh De Fontaine, NP
• Christina Anne-Josiane De Fontnouvelle, MD
• Luciana De Franco Marcondes Gomes
• Susanna Willemina Leuntje De Geus, MD PHD

• General Practice Dentistry in Boston, MA
• Providers in Boston, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; 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.