SMILE DESIGN BOSTON (NPI# 1992294979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992294979 |
| Entity Type | Organization |
| Organization Name | SMILE DESIGN BOSTON |
| Other Organization Name | SMILE DESIGN BOSTON |
| Practice Address |
21 Custom House St Ste 110 Boston MA 02110-3525 |
| Mailing Address |
15 Waverly St Apt 260 Brighton MA 02135-1245 |
| Practice Telephone | 6178400627 |
| Mailing Telephone | 6178400627 |
| Enumeration Date | 2018-05-06 |
| Last Update Date | 2018-05-06 |
| Authorized Official Name | DR. ANDRE HASHEM (OWNER) |
| Authorized Official Telephone | 6178400627 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
DN1856740 | MA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DELTA DENTAL PREMIER | 1487727301 | 01 | |
| BLUE CROSS BLUE SHIELD DENTAL | 1487727301 | 01 |
| Other Name | Type Code |
|---|---|
| Smile Design Boston | Doing Business As Name - Organization |
| Street Address |
21 CUSTOM HOUSE ST STE 110 |
| City | BOSTON |
| State | MA |
| Zip Code | 02110-3525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326657487 | Laqueen Arleen Battle | Counselor | 101 Arch Street, 8th Floor, Ste 869, Boston, MA 02110 | 2020-07-24 |
| 1164051033 | Arthur Paul Brodie | Massage Therapist | Boston Athletic Club, 653 Summer St., Boston, MA 02110 | 2020-04-03 |
| 1588146286 | Erin Collette Kenney | Dietitian, Registered | 5 Fan Peir Boulevard, Boston, MA 02110 | 2018-08-30 |
| 1316430705 | Jennifer B Ash | Psychologist | 101 Federal St Ste 1900, Boston, MA 02110 | 2018-06-11 |
| 1063930501 | Rachel Duda | Psychologist | 185 Devonshire Street Suite 901, Boston, MA 02110 | 2017-09-05 |
| 1770892101 | Chiajou Lu | Marriage & Family Therapist | 185 Devonshire St Ste 500, Boston, MA 02110 | 2010-10-04 |
| 1518298975 | Thom Delahunt | Marriage & Family Therapist | 185 Devonshire St Ste 503, Boston, MA 02110 | 2010-01-26 |
| 1710133582 | Pamela Marie Maragliano | Dentist | Lewis Wharf Bay 237, Boston, MA 02110 | 2008-08-13 |
| 1962672774 | Laura Marie Daniels | Acupuncturist | 185 Devonshire St., Suite 201, Boston, MA 02110 | 2008-03-07 |
| 1609060896 | Robert J. Chapman | Dentist | 28 Atlantic Ave. Lewis Wharf, Boston, MA 02110 | 2007-08-30 |
| Find all providers in zip 02110 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871134833 | Supontep Teerakanok | Dentist | Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118 | 2019-10-01 |
| 1437700218 | Mansour Alasiri | Dentist | 650 Albany St Ste 341, Boston, MA 02118-2518 | 2019-09-24 |
| 1508417338 | Bushra Aljahdali | Dentist | 650 Albany St Fl 3, Boston, MA 02118-2518 | 2019-09-23 |
| 1043863533 | Ricardo Lazaro Pascual | Dentist | 1 Kneeland St Dept, Boston, MA 02111-1527 | 2019-07-23 |
| 1245739291 | Maryam A Alsendi | Dentist | 100 E Newton St Ste G217, Boston, MA 02118-2308 | 2018-02-05 |
| 1528590783 | Rayan Al Edreesi | Dentist | 100 E Netwton St, Suite G-217, Boston, MA 02118 | 2017-03-28 |
| 1013457290 | Majed Khalid M Alshehri | Dentist | 100 East Newton Street Boston, Boston, MA 02118 | 2017-03-07 |
| 1699105734 | Perico Back Bay, LLC | Dentist | 400 Commonwealth Ave. 3rd Flr., Boston, MA 02215 | 2013-11-26 |
| 1639429525 | Majdi Ahmed Aladmawy | Dentist | 1 Kneeland St, Dhs 15, Boston, MA 02111 | 2012-09-18 |
| 1467702373 | Zuhair Natto | Dentist | One Kneeland St, Dhs 15th Floor, Boston, MA 02111 | 2012-09-18 |
| Find all providers in BOSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.