NPI 1255228755 · live from the CMS NPI Registry
Palak Bothra
Dentist, Orthodontics and Dentofacial Orthopedics in Boston, MA. National Provider Identifier 1255228755, active.
NPI record
| NPI | 1255228755 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 635 Albany St, Boston, MA 02118 |
| Practice phone | 952-855-2188 |
| Mailing address | 1410 Columbia Rd Apt 1g, South Boston, MA 02127 |
| Enumerated | June 18, 2025 |
| Last updated | June 18, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | DL100422 (MA) |
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | DL100422 (MA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.