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PERICO BACK BAY, LLC
NPI 1699105734
Dentist - Periodontics in Boston, MA

Active since November 26, 2013
400 COMMONWEALTH AVE. 3RD FLR., BOSTON, MA 02215(617) 456-9714(617) 266-9530 Get Directions Write a Review

NPPES record last updated: November 26, 2013. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Perico Back Bay, Llc NPPES

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

PERICO BACK BAY, LLC (NPI 1699105734) is a healthcare organization registered as a periodontics in Boston, Massachusetts and active in the NPI registry since November 2013. The organization lists Gary M. Reiser, Managing Doctor, as its authorized official.

NPPES Registry Identity

NPI1699105734
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NamePERICO BACK BAY, LLC
Location Address400 COMMONWEALTH AVE. 3RD FLR.Boston, MA 02215
Mailing Address400 Commonwealth Ave. 3rd Flr.Boston, MA 02215 · (617) 456-9714 · Fax (617) 266-9530
Phone(617) 456-9714
Fax(617) 266-9530
Organization SubpartNo
Authorized OfficialGary M. ReiserManaging Doctor · (617) 456-9714
Enumeration DateNovember 26, 2013
✔ NPI 1699105734 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
400 COMMONWEALTH AVE. 3RD FLR., Boston, MA 02215
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Perico Back Bay, LLC's NPI number?

The NPI number for Perico Back Bay, LLC is 1699105734. It was assigned to this organization in the NPPES registry on November 26, 2013.

Where is Perico Back Bay, LLC located?

Perico Back Bay, LLC is located at 400 Commonwealth Ave. 3rd Flr., Boston, MA 02215. The listed phone number is (617) 456-9714.

What is Perico Back Bay, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Perico Back Bay, LLC was last updated on November 26, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.