Individual provider Active NPI

Amjad Alabdulmohsen

  • Dentist
  • Boston, MA
National Provider Identifier
1912673724
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DL15340 Issued in MA
Practice address
1 Kneeland St FL 8
Boston, MA 02111-1527
Phone
(617) 636-3898
NPI assigned
Aug 20, 2021
Last updated
Aug 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DL14937 MA
Dentist 122300000X DL15340 MA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1 Kneeland St FL 8
Boston, MA 02111-1527

Mailing address

660 Washington St Apt 20J
Boston, MA 02111-3230
Phone (617) 892-1594

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

LicenseStateTypeSpecialty
DL14937MAMDDentist
DL15340MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1912673724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 WASHINGTON ST APT 20J",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021113230",
            "telephone_number": "617-892-1594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST FL 8",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-3898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALABDULMOHSEN",
        "first_name": "AMJAD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DL14937",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DL15340",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.