1. Home
  2. Directory
  3. Massachusetts
  4. Boston
  5. Dentist
  6. NPI Profile

DIBA DASTJERDI DMD
NPI 1629273776
Dentist - General Practice in Boston, MA

Active since June 19, 2007PECOS Enrolled
68 NEW EDGERLY ROAD, BOSTON, MA 02115(617) 262-5880(617) 859-8804 Get Directions Write a Review

NPPES record last updated: April 26, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Diba Dastjerdi Dmd NPPES

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

DIBA DASTJERDI DMD (NPI 1629273776) is an individual general practice provider in Boston, Massachusetts, licensed in Massachusetts (21835) and active in the NPI registry since June 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629273776
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameDIBA DASTJERDICredential: DMD
Location Address68 NEW EDGERLY ROADBoston, MA 02115
Mailing Address68 New Edgerly RoadBoston, MA 02115 · (617) 262-5880 · Fax (617) 859-8804
Phone(617) 262-5880
Fax(617) 859-8804
Sole ProprietorNo
Enumeration DateJune 19, 2007
Last NPPES UpdateApril 26, 2013
✔ NPI 1629273776 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MA · 21835
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.
68 NEW EDGERLY ROAD, Boston, MA 02115
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, BEST Life and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Diba Dastjerdi Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02115 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$97.64 typical visit price
range $63.72 – $189.86
Typical copayment $24.41 (range $15.93 – $47.46)
Most-billed visit code 99203
Established Patient
$78.84 typical visit price
range $21.07 – $155.29
Typical copayment $19.71 (range $5.26 – $38.82)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

ASHKAN SAMADZADEH DMD
Dentist (General Practice)
68 NEW EDGERLY ROAD
BOSTON, MA 02115
Suffolk County (617) 262-5880

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Diba Dastjerdi's NPI number?

The NPI number for Diba Dastjerdi is 1629273776. It was assigned to this individual provider in the NPPES registry on June 19, 2007.

Where is Diba Dastjerdi located?

Diba Dastjerdi practices at 68 New Edgerly Road, Boston, MA 02115. The listed phone number is (617) 262-5880.

What is Diba Dastjerdi's specialty?

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

Is Diba Dastjerdi enrolled in Medicare?

Yes. Diba Dastjerdi is registered in the Medicare PECOS enrollment system.

What insurance does Diba Dastjerdi accept?

Health plans from Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 6 other insurers list Diba Dastjerdi as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Diba Dastjerdi was last updated on April 26, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.