NPIMap

Organization Active NPI

Boylston Street Dental, LLC

  • Dentist
  • Chestnut Hill, MA
National Provider Identifier
1922513597
Registry record updated Dec 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
BOYLSTON STREET DENTAL, LLC
Practice address
300 Boylston St Ste 202
Chestnut Hill, MA 02467-1959
Phone
(617) 566-6900
NPI assigned
Dec 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2017

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

Authorized official

Name
Dr. Adam Charles Polivy, DMD
Title
Partner
Phone
(617) 566-6900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

300 Boylston St Ste 202
Chestnut Hill, MA 02467-1959

Mailing address

300 Boylston St Ste 202
Chestnut Hill, MA 02467-1959
Phone (617) 566-6900

Other names 1

  • Boylston Street Dental Group Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512432000000",
    "number": "1922513597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BOYLSTON ST STE 202",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024671959",
            "telephone_number": "617-566-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BOYLSTON ST STE 202",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024671959",
            "telephone_number": "617-566-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYLSTON STREET DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-05",
        "last_updated": "2017-12-05",
        "status": "A",
        "authorized_official_last_name": "POLIVY",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "617-566-6900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boylston Street Dental Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chestnut Hill, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; 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.