Aesthetic Services Inc.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

AESTHETIC SERVICES INC.

Practice address

1340 Beacon St
Brookline, MA 02446-3201

Phone

(617) 906-8115

NPI assigned

Nov 25, 2020

Organization subpart

No

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

Authorized official

Name

Diana Brouillard

Title

Owner

Phone

(617) 906-8115

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• DREAM SPA MEDICAL INC. Doing business as
• Dream Spa Medical Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606262400000",
    "number": "1992309306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 BEACON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463201",
            "telephone_number": "617-906-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 BEACON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463201",
            "telephone_number": "617-906-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AESTHETIC SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-25",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A",
        "authorized_official_last_name": "BROUILLARD",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-906-8115"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE PRACTICE",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clinical@dreamspamedical.com",
            "affiliation": "N",
            "endpointDescription": "clinical email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1340 Beacon St",
            "city": "Brookline",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024463201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "DREAM SPA MEDICAL INC.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dream Spa Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Brookline, MA
• Plastic Surgery Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.