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PRESIDENT AND FELLOWS OF HARVARD COLLEGE NPI 1164512570


NPI Information

NPI: 1164512570
Provider Name: PRESIDENT AND FELLOWS OF HARVARD COLLEGE

Doing Business As: HARVARD DENTAL CENTER FGP

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
188 LONGWOOD AVE
BOSTON, MA
ZIP 02115
Phone: (617) 432-1434
Get Directions

PRESIDENT AND FELLOWS OF HARVARD COLLEGE is a general practice dentist in Boston, MA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. PRESIDENT AND FELLOWS OF HARVARD COLLEGE NPI is 1164512570. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Harvard Dental Center Fgp.

The provider's business location address is:

188 LONGWOOD AVE
BOSTON, MA
ZIP 02115-819
Phone: (617) 432-1434
Fax: (617) 432-4258

The provider's authorized official is John Da Silva .
The authorized official title is Medical Director and has the following contact phone number (617) 432-1440.

The enumeration date for this NPI number is 10/14/2006 and was last updated on 2/17/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223P0300XDentistPeriodontics16638MASSACHUSETTSNo
21223P0700XDentistProsthodontics16484MASSACHUSETTSNo
31223E0200XDentistEndodontics12762MASSACHUSETTSNo
41223S0112XDentistOral and Maxillofacial Surgery14710MASSACHUSETTSNo
51223X0400XDentistOrthodontics and Dentofacial Orthopedics9239MASSACHUSETTSNo
61223G0001XDentistGeneral Practice17724MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10200140MEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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