Organization Active NPI

Waverly Endodontics Group LLC

  • Endodontics
  • Boston, MA
National Provider Identifier
1962323733
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
WAVERLY ENDODONTICS GROUP LLC
Practice address
800 Boylston St FL 2
Boston, MA 02199-8081
Phone
(617) 841-8436
NPI assigned
Jul 24, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Authorized official

Name
Garrett Waverly Wingrove, DMD, CAGS, MSD
Title
Endodontist
Phone
(617) 955-3331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

800 Boylston St FL 2
Boston, MA 02199-8081

Mailing address

45 1St Ave Apt 4
Boston, MA 02129-4560
Phone (617) 955-3331

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1784851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784851200000",
    "number": "1962323733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 1ST AVE APT 4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021294560",
            "telephone_number": "617-955-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BOYLSTON ST FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021998081",
            "telephone_number": "617-841-8436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVERLY ENDODONTICS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-24",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A",
        "authorized_official_last_name": "WINGROVE",
        "authorized_official_first_name": "GARRETT",
        "authorized_official_middle_name": "WAVERLY",
        "authorized_official_title_or_position": "ENDODONTIST",
        "authorized_official_telephone_number": "617-955-3331",
        "authorized_official_credential": "DMD, CAGS, MSD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Jul 24, 2026; 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.