HARVARD DENTAL CENTER FGP
NPI 1164512570
Dentist - General Practice in Boston, MA

Q: What is President And Fellows Of Harvard College's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since October 14, 2006CLIA 22D2117392 · Waiver

188 LONGWOOD AVE, BOSTON, MA 02115(617) 432-1434(617) 432-4258 Get Directions Write a Review

NPPES record last updated: February 17, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Harvard Dental Center Fgp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HARVARD DENTAL CENTER FGP (NPI 1164512570) is a healthcare organization registered as a general practice in Boston, Massachusetts and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through August 15, 2026 and lists John Da Silva, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1164512570

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NamePRESIDENT AND FELLOWS OF HARVARD COLLEGE

Location Address188 LONGWOOD AVEBoston, MA 02115-5819

Mailing Address188 Longwood AveBoston, MA 02115-5819 · (617) 432-1434 · Fax (617) 432-4258

Phone(617) 432-1434

Fax(617) 432-4258

Organization SubpartNo

Authorized OfficialJohn Da SilvaMedical Director · (617) 432-1440

Enumeration DateOctober 14, 2006

Last NPPES UpdateFebruary 17, 2016

✔ NPI 1164512570 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in MA · 17724

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Also ListedDentist · EndodonticsTaxonomy 1223E0200X · License 12762 (MA)

Also ListedDentist · PeriodonticsTaxonomy 1223P0300X · License 16638 (MA)

Also ListedDentist · ProsthodonticsTaxonomy 1223P0700X · License 16484 (MA)

Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License 14710 (MA)

Also ListedDentist · Orthodontics and Dentofacial OrthopedicsTaxonomy 1223X0400X · License 9239 (MA)

188 LONGWOOD AVE, Boston, MA 02115

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Other Names 1

Doing Business AsHarvard Dental Center Fgp

Other Identifiers 1

Medicaid0200140MA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 22D2117392

Harvard Dental Center · Boston, MA

Active · expires Aug 15, 2026

CLIA Number22D2117392

Laboratory TypeDental School

Certificate Effective DateAugust 16, 2024

Certificate Expiration DateAugust 15, 2026

Laboratory DirectorJohn D. Dasilva

Laboratory Phone(617) 432-1434

Laboratory LocationHarvard Dental Center188 Longwood Avenue, Boston, MA 02115

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICHA TOKAVANICH DDS

Dentist