NPIMap

Organization Active NPI

Prudential Dental Associates Inc.

  • Dentist
  • Boston, MA
National Provider Identifier
1972745891
Registry record updated Mar 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
20677 Issued in MA
Legal business name
PRUDENTIAL DENTAL ASSOCIATES INC.
Practice address
575 Boylston St
7TH Floor
Boston, MA 02116-3607
Phone
(617) 267-3889
Fax
(617) 267-3819
NPI assigned
Mar 25, 2009
Last updated
Mar 25, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2009

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

Authorized official

Name
Dr. Alex Adeli, MDMNPI 1861540221
Title
President
Phone
(617) 267-3889

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 20677 MA Primary

Addresses

Primary practice location

575 Boylston St
7TH Floor
Boston, MA 02116-3607

Mailing address

575 Boylston St
7TH Floor
Boston, MA 02116-3607
Phone (617) 267-3889

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237939200000",
    "number": "1972745891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 BOYLSTON ST",
            "address_2": "7TH FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021163607",
            "telephone_number": "617-267-3889",
            "fax_number": "617-267-3819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 BOYLSTON ST",
            "address_2": "7TH FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021163607",
            "telephone_number": "617-267-3889",
            "fax_number": "617-267-3819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUDENTIAL DENTAL ASSOCIATES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-25",
        "last_updated": "2009-03-25",
        "status": "A",
        "authorized_official_last_name": "ADELI",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-267-3889",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MDM"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "20677",
            "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 Mar 25, 2009; 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.