TRUSTEES OF BOSTON UNIVERSITY (NPI# 1285867986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285867986 |
| Entity Type | Organization |
| Organization Name | TRUSTEES OF BOSTON UNIVERSITY |
| Other Organization Name | BU ORAL SURGERY GROUP PRACTICE |
| Practice Address |
830 Harrison Ave Boston MA 02118-2905 |
| Mailing Address |
100 E Newton St Rm G317 Boston MA 02118-2308 |
| Practice Telephone | 8663901815 |
| Mailing Telephone | 6176385932 |
| Mailing Fax Number | 6176384490 |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2009-08-27 |
| Authorized Official Name | DR. JEFFREY W HUTTER (DEAN) |
| Authorized Official Telephone | 6176384780 |
| Authorized Official Credential | D.M.D., M.ED |
| Is Organization Subpart | Y |
| Parent Organization Name | TRUSTEES OF BOSTON UNIVERSITY HENRY M. GOLDMAN SCHOOL OF DENTAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
4954 | MA | Dental Providers |
| Other Name | Type Code |
|---|---|
| BU Oral Surgery Group Practice | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013242239 | Trustees of Boston University | Nutritionist | 635 Commonwealth Ave., 6th Floor, Boston, MA 02215-1605 | 2009-10-06 |
| 1174701189 | Trustees of Boston University | Clinical Medical Laboratory | 24 Cummington St, Room 724, Boston, MA 02215-2425 | 2008-02-01 |
| 1053419598 | Trustees of Boston University | Clinic/Center | 185 Bay State Rd, Boston, MA 02215-1506 | 2006-09-20 |
| 1265419568 | Trustees of Boston University | Physical Therapist | 915 Commonwealth Ave Rear, Boston, MA 02215-1394 | 2005-12-28 |
| 1578909750 | Trustees of Boston University | Dentist | 840 Harrison Ave, Boston, MA 02118-2905 | 2013-05-15 |
| 1053757245 | Trustees of Boston University | Dentist | 110 Francis St, Boston, MA 02215-5501 | 2013-05-15 |
| 1326483074 | Trustees of Boston University | Dentist | 725 Albany St, Boston, MA 02118-2526 | 2013-05-08 |
| 1821221524 | Trustees of Boston University | Dentist | 850 Harrison Ave, 5th Floor, Boston, MA 02118-4001 | 2009-08-27 |
| 1720211428 | Trustees of Boston University | Dentist | 30 Warren St, Boston, MA 02135-3602 | 2009-08-27 |
| 1043443732 | Trustees of Boston University | Dentist | 88 E Newton St, Boston, MA 02118-2308 | 2009-08-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Trustees of Boston University | One Silber Way, Boston, Massachusetts 02215 |
| Iowa Business Entities | TRUSTEES OF BOSTON UNIVERSITY | One Silber Way, Boston, MA 02215 |
| Massachusetts Corporations | TRUSTEES OF BOSTON UNIVERSITY | One Silber Way, Boston, MA 02215 |
| Washington State Corporations | TRUSTEES OF BOSTON UNIVERSITY | One Silber Way, Boston, MA 02215 |
| Colorado Business Entities | Trustees of Boston University | One Silber Way, Boston, MA 02215 |
| Oklahoma Business Registrations | TRUSTEES OF BOSTON UNIVERSITY | Attn: Todd Klipp, General Counsel, Boston University, One Silber Way, Boston, MA 02215 |
| Street Address |
830 HARRISON AVE |
| City | BOSTON |
| State | MA |
| Zip Code | 02118-2905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316937436 | Minh Tam Truong | Radiology | 830 Harrison Ave, Moakley Building Ll100, Boston, MA 02118 | 2005-10-28 |
| 1457950131 | Maggie Ruderman | Genetic Counselor, MS | 830 Harrison Ave, Boston, MA 02118-2905 | 2020-10-22 |
| 1760096606 | Fabio Petrocca | Student in an Organized Health Care Education/Training Program | 830 Harrison Ave, Boston, MA 02118-2905 | 2020-09-08 |
| 1801447495 | Kailey Vitale | Speech-Language Pathologist | 830 Harrison Ave, Boston, MA 02118-2905 | 2019-09-25 |
| 1437718228 | Kayla Mcdonald | Physician Assistant | 830 Harrison Ave, Moakley, Suite 3400, Boston, MA 02118 | 2019-06-06 |
| 1154984888 | Elizabeth Tiani | Nurse Practitioner | 830 Harrison Ave, Boston, MA 02118 | 2019-04-18 |
| 1669938981 | Lynsie Rae Adams | Nurse Practitioner | 830 Harrison Ave, Moakley, 3rd Floor, Boston, MA 02118 | 2019-02-11 |
| 1548754385 | Lisa Jiyoung Kim | Nurse Practitioner | 830 Harrison Ave, Moakley, 3rd Floor, Boston, MA 02118 | 2018-06-15 |
| 1891226650 | Navid Alavi | Internal Medicine | 830 Harrison Ave, Moakley, 3rd Floor, Boston, MA 02118 | 2017-03-23 |
| 1952842189 | Samuel Rubin | Otolaryngology | 830 Harrison Ave, 1st Floor, Boston, MA 02118-2905 | 2017-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649870023 | Carlos E Salazar | Counselor | Hcrc 23 Bradston St., Boston, MA 02118 | 2020-10-27 |
| 1780292607 | Jinal Gandhi | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Boston, MA 02118 | 2020-07-16 |
| 1669094777 | German Eduardo Velez | Student in an Organized Health Care Education/Training Program | One Boston Medical Center Place Boston Medical Center, Boston, MA 02118 | 2020-05-12 |
| 1255969895 | Isabela Medeiros Heringer Pereira | Student in an Organized Health Care Education/Training Program | 670 Albany Stree, 4th Floor, Boston, MA 02118 | 2020-03-30 |
| 1033746466 | Karan Sunil Hingorani | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Precepting Room, Boston, MA 02118 | 2020-03-25 |
| 1326672791 | Azza Ahmed | Dentist | 635 Albany St. G-744, Boston, MA 02118 | 2020-02-25 |
| 1538707401 | Jane Margolis | Social Worker | 840 Harrison Ave., Dowling 2 South, Boston, MA 02118 | 2019-12-11 |
| 1871134833 | Supontep Teerakanok | Dentist | Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118 | 2019-10-01 |
| 1750939583 | Qasim Silman Ajmi | Orthopaedic Surgery | Department of Orthopaedic Surgery Boston Medical Center, 850 Harrison Ave Dowling 2 North, Boston, MA 02118 | 2019-08-26 |
| 1922655539 | Jami Ryan Pollard | Physician Assistant | 840 Harrison Avenue, Menino Building, Boston, MA 02118 | 2019-08-20 |
| Find all providers in zip 02118 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528592029 | Jaegak Kim | Dentist | 850 Harrison Ave Fl 6, Boston, MA 02118-4001 | 2017-04-12 |
| 1053750893 | Allan Wun | Dentist | 1 Kneeland St., 5th Floor/ Dhs 503, Boston, MA 02111 | 2013-06-14 |
| 1609189018 | Stavros Oikonomou | Dentist | 660 Washington St Apt 25g, Boston, MA 02111-3243 | 2010-07-15 |
| 1073825352 | Cristobal Alberto Quevedo | Dentist | 761 Harrison Ave Apt 205, Boston, MA 02118-2362 | 2010-07-02 |
| 1740591080 | Ahmad Ali Alshadwi | Dentist | 850 Harrison Ave Fl Acc5, Boston Medical Center Oral Surgery Department, Boston, MA 02118-4001 | 2010-07-01 |
| 1437390481 | Behzad Mostoufi | Dentist | 820 Harrison Ave # Acc5, Boston, MA 02118-2905 | 2009-03-19 |
| 1396991089 | Jennifer E. Smith-williams, D.m.d. | Dentist | 575 Boylston St Fl 5, Boston, MA 02116-3607 | 2008-08-13 |
| 1497923791 | Mario S Lucca | Dentist | 185 Dartmouth St Ste 403, Boston, MA 02116-5883 | 2008-02-20 |
| 1225228422 | Steven John Scrivani | Dentist | One Kneeland Street, Suite 601, Boston, MA 02111 | 2007-07-25 |
| 1215138672 | Constantinos Laskarides | Dentist | 1 Kneeland St Rm 503, Boston, MA 02111-1527 | 2007-05-31 |
| 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.