PRESIDENT AND FELLOWS OF HARVARD COLLEGE (NPI# 1881852713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881852713 |
| Entity Type | Organization |
| Organization Name | PRESIDENT AND FELLOWS OF HARVARD COLLEGE |
| Other Organization Name | HARVARD DENTAL CENTER |
| Practice Address |
188 Longwood Ave Boston MA 02115-5819 |
| Practice Telephone | 6174321401 |
| Practice Fax Number | 6174324258 |
| Mailing Telephone | 6174321401 |
| Mailing Fax Number | 6174324258 |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2008-05-28 |
| Authorized Official Name | DR. ROBERT BRUCE DONOFF (DEAN) |
| Authorized Official Telephone | 6174321401 |
| Authorized Official Credential | DMD MD |
| Is Organization Subpart | Y |
| Parent Organization Name | PRESIDENT AND FELLOWS OF HARVARD COLLEGE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
37230 | MA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 0200140 | 05 |
| Other Name | Type Code |
|---|---|
| Harvard Dental Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073947396 | President and Fellows of Harvard College | Clinic/Center | 75 Mount Auburn St, Cambridge, MA 02138-4960 | 2013-08-22 |
| 1093069858 | President and Fellows of Harvard College | Clinic/Center | 188 Longwood Ave, Boston, MA 02115-5819 | 2012-11-01 |
| 1972761807 | President and Fellows of Harvard College | Dentist | 188 Longwood Ave, Boston, MA 02115-5819 | 2008-05-28 |
| 1164512570 | President and Fellows of Harvard College | Dentist | 188 Longwood Ave, Boston, MA 02115-5819 | 2006-10-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PRESIDENT AND FELLOWS OF HARVARD COLLEGE | 1033 Massachusetts Ave 5th Fl, Cambridge, MA 02138-5369 |
| Street Address |
188 LONGWOOD AVE |
| City | BOSTON |
| State | MA |
| Zip Code | 02115-5819 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689664849 | Thomas R Flynn | Dentist | 188 Longwood Ave, Boston, MA 02115-5819 | 2005-10-27 |
| 1346857869 | Saad Almujel | Dentist | 188 Longwood Ave, Boston, MA 02115-5819 | 2020-09-29 |
| 1548878176 | Ionut Sebastian Viski | Dentist | 188 Longwood Ave, Boston, MA 02115-5819 | 2020-07-20 |
| 1962010504 | Ankita Arunkumar Nigam | Dentist | 188 Longwood Ave, Boston, MA 02115-5819 | 2020-07-20 |
| 1013525708 | Min Jeong | Dentist | 188 Longwood Ave, Boston, MA 02115-5819 | 2020-07-19 |
| 1235747395 | Yujun Wang | Dentist | 188 Longwood Ave, Boston, MA 02115-5819 | 2020-07-15 |
| 1346868692 | Asmaa Faisal Bukhari | Dentist | 188 Longwood Ave, Boston, MA 02115-5819 | 2020-07-13 |
| 1003433160 | Nicha Tokavanich | Student in an Organized Health Care Education/Training Program | 188 Longwood Ave, Boston, MA 02115-5819 | 2020-07-06 |
| 1134746464 | Justin Lewis Tomack | Dentist | 188 Longwood Ave, Boston, MA 02115-5819 | 2020-07-02 |
| 1144847526 | Morgan Celistan | Dentist | 188 Longwood Ave, Boston, MA 02115-5819 | 2020-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524339 | Jacqueline Busa | Student in an Organized Health Care Education/Training Program | Northeastern University 336 Huntington Ave, Boston, MA 02115 | 2020-09-30 |
| 1417564279 | Katherine Rose Brainard | Student in an Organized Health Care Education/Training Program | 336 Huntington Avenue, Boston, MA 02115 | 2020-09-25 |
| 1679189112 | Tara Baxter | Orthopaedic Surgery | Boston Children's Hospital - Sports Medicine Division, 319 Longwood Avenue, Boston, MA 02115 | 2020-09-21 |
| 1053923110 | Wendy Tu | Student in an Organized Health Care Education/Training Program | 75 Francis Street Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115 | 2020-08-20 |
| 1477177335 | Nicolas Wyvekens | Student in an Organized Health Care Education/Training Program | 75 Francis Street Department of Pathology, Brigham And, Boston, MA 02115 | 2020-06-05 |
| 1669095923 | Erin Crocker | Student in an Organized Health Care Education/Training Program | Northeastern University Physician Assistant Program, 360 Huntington Avenue, Boston, MA 02115 | 2020-05-21 |
| 1033732417 | Tyler Francis Hayes | Student in an Organized Health Care Education/Training Program | Gordon Hall, Suite 213, 25 Shattuck Street, Boston, MA 02115 | 2020-05-20 |
| 1982225090 | Emily Blake | Student in an Organized Health Care Education/Training Program | 202 Robinson Hall, 360 Huntington Avenue, Boston, MA 02115 | 2020-04-29 |
| 1891315495 | Stephanie Schoch | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave., 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| 1427678093 | Meghan Miles | Student in an Organized Health Care Education/Training Program | 360 Huntington Avenue 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| Find all providers in zip 02115 | ||||
| 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.