NPIMap

Organization Active NPI

President and Fellows of Harvard College

  • General Practice Dentistry
  • Boston, MA
National Provider Identifier
1972761807
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16484 Issued in MA
Legal business name
PRESIDENT AND FELLOWS OF HARVARD COLLEGE
Practice address
188 Longwood Ave
Boston, MA 02115-5819
Phone
(617) 432-1440
NPI assigned
May 28, 2008
Organization subpart
Yes
Parent organization
PRESIDENT AND FELLOWS OF HARVARD COLLEGEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Authorized official

Name
Dr. John Da Silva, DMD
Title
Medical Director
Phone
(617) 432-1440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 16484 MA Primary

Addresses

Primary practice location

188 Longwood Ave
Boston, MA 02115-5819

Mailing address

188 Longwood Ave
Boston, MA 02115-5819
Phone (617) 432-1440

Other identifiers 1

IdentifierTypeStateIssuer
0200140MedicaidMA

Other names 1

  • Harvard Dental Center TP Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322001750 MA Part B Supplier - Clinic/Group Practice 2062303894 Receives reassigned benefits from 170 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boston, MA; Cambridge, MA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
President Fellows of Harva17 organizations share this tax ID, including this one
Part of
President Fellows of Harva

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

33 Harvard Way
Boston, MA 02163
Phone (617) 495-6455

275 Longwood Ave
Boston, MA 02115
Phone (617) 432-1370

Practitioners & affiliated clinicians

Practitioners 182

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 182

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357516800000",
    "number": "1972761807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155819",
            "telephone_number": "617-432-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155819",
            "telephone_number": "617-432-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESIDENT AND FELLOWS OF HARVARD COLLEGE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRESIDENT AND FELLOWS OF HARVARD COLLEGE",
        "enumeration_date": "2008-05-28",
        "last_updated": "2013-01-07",
        "status": "A",
        "authorized_official_last_name": "DA SILVA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "617-432-1440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "16484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0200140",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harvard Dental Center TP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.