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NPI 1588919807ActiveIndividual· Dentist· Allston, MA

Dentist in Allston, Massachusetts, licensed in MA, with an NPI issued in July 2012.

Overview

NPI1588919807
StatusActive
Entity typeIndividual
Sole proprietorNo
NPI issuedJul 24, 2012
Last updated in NPPESJul 24, 2012

Specialties and licenses

TaxonomyCodeLicenseState
Dentist Primary122300000XDN1856057MA

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Industry payments (Open Payments)

None reported for 2025 or 2024.

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records

Other Dentist providers in Allston

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