Individual provider Active NPI

Ram P Yadav

  • Dentist
  • Medford, MA
National Provider Identifier
1972117414
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1858824 Issued in MA
Practice address
30 Main St
Medford, MA 02155-7102
Phone
(781) 391-2440
NPI assigned
Sep 2, 2020
Last updated
Oct 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MA
Dentist 122300000X DN1858824 MA Primary

Addresses

Primary practice location

30 Main St
Medford, MA 02155-7102

Mailing address

20 Summer St Apt 903
Malden, MA 02148-3914
Phone (573) 639-0497

Other practice location 1

Boston University Henry M. Goldman School of Dental Med
635 Albany St
Boston, MA 02118
Phone (617) 358-8300

Other practice location 2

290 Ferry St
Malden, MA 02148-7114
Phone (573) 639-0497

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ramyadav@bu.edu Boston University Henry M. Goldman school of Dental Medicine
Direct Messaging Address ramyadav@bu.edu

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
DN1858824MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Medford Square Dentistry and Implants LLC CurrentSince Aug 15, 2021 Accepting new patients
Needham Dentistry & Implants PC Current Accepting new patients
Unident Dental Group LLC CurrentSince Jun 27, 2021 Accepting new patients
Taunton Dentistry & Implants PC Current Accepting new patients
Malden Dentistry & Implants PC PastSince May 7, 2023 Accepting new patients
Nanette Demonteverde, DMD, PC PastSince Oct 8, 2023 Accepting new patients
First Commonwealth Dental LLC PastSince Oct 8, 2023 Accepting new patients

Locations

30 Main St
Medford, MA 02155
Phone (781) 391-2440

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1972117414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SUMMER ST APT 903",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021483914",
            "telephone_number": "573-639-0497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MAIN ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021557102",
            "telephone_number": "781-391-2440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Boston University Henry M. Goldman School of Dental Med",
            "address_2": "635 Albany St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02118",
            "country_code": "US",
            "telephone_number": "617-358-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "290 Ferry St",
            "address_purpose": "LOCATION",
            "city": "Malden",
            "state": "MA",
            "postal_code": "021487114",
            "country_code": "US",
            "telephone_number": "573-639-0497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YADAV",
        "first_name": "RAM",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-02",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1858824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ramyadav@bu.edu",
            "affiliation": "Y",
            "endpointDescription": "email address",
            "affiliationName": "Boston University Henry M. Goldman school of Dental Medicine",
            "address_1": "Boston University Henry M. Goldman School of Dental Med",
            "address_2": "635 Albany St",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "02118",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ramyadav@bu.edu",
            "affiliation": "N",
            "endpointDescription": "email address",
            "address_1": "578 Main St # 101",
            "city": "Malden",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021483900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.