Chestnut Hill Dental
Dentist, General Practice in Chestnut Hill, MA. Organization (NPI-2).
NPI number1104084003
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1104084003
- Entity type
- Organization (NPI-2)
- Legal business name
- Chestnut Hill Dental
- Organization subpart
- No
- Enumeration date
- May 28, 2008
- Last updated
- Jul 21, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | MA | Yes |
Other names
- Spa At Chestnut Hill Dental (Other Name)
Practice location
631a Vfw PkwyChestnut Hill, MA 02467-3656
Phone 617-327-3500
Mailing address
631a Vfw PkwyChestnut Hill, MA 02467-3656
Authorized official
Richard A. Rosen
Doctor
6173273500
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 13 General Practice Dentistry providers in Chestnut Hill · All 910 providers in Chestnut Hill
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