Unknown Individual – Pediatric Dentistry, NPI 1639186083

Unknown Individual is a healthcare provider. based in Boston, Massachusetts. specializing in Pediatric Dentistry. They hold a License No. 11712 (MA). The NPI Number for Unknown Individual is 1639186083

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1639186083
Phone
(617) 262-5880
Address
68 NEW EDGERLY ROAD
Deactivation Date
31 January 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 68 NEW EDGERLY ROAD

    BOSTON, MA 02115

    Phone: (617) 262-5880

    Fax: (617) 859-8804

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02115)

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Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1639186083.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Pediatric Dentistry in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Boston, Massachusetts?
If you are local to Boston, Massachusetts, Unknown Individual may be relevant to your search.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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