NPIMap

Organization Active NPI

Doctors of West Roxbury LLC

Doing business as Citidental West Roxbury

  • General Practice Dentistry
  • West Roxbury, MA
National Provider Identifier
1891462420
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DOCTORS OF WEST ROXBURY LLC
Doing business as
Citidental West Roxbury
Practice address
172 Spring St
West Roxbury, MA 02132-5020
Phone
(617) 323-5000
NPI assigned
Aug 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Authorized official

Name
Lina Badawi
Title
Manager
Phone
(617) 817-3312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

172 Spring St
West Roxbury, MA 02132-5020

Mailing address

63 Court St
Boston, MA 02108-2109

Other names 1

  • Citidental West Roxbury Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629676800000",
    "number": "1891462420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 COURT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021082109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 SPRING ST",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021325020",
            "telephone_number": "617-323-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS OF WEST ROXBURY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A",
        "authorized_official_last_name": "BADAWI",
        "authorized_official_first_name": "LINA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "617-817-3312"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Citidental West Roxbury",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Roxbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.