Active NPI
Amjad Alabdulmohsen
- Dentist
- Boston, MA
National Provider Identifier
1912673724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DL15340
- Practice address
- 1 Kneeland St FL 8
Boston, MA 02111-1527 - Phone
- (617) 636-3898
- NPI assigned
- Aug 20, 2021
- Last updated
- Aug 31, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| DL14937 | MA | MD | Dentist |
| DL15340 | MA | MD | Dentist |
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.