Komyati, Stephen

Komyati, Stephen is an individual health care provider with primary practice located at 133 Brookline Ave , Boston MA 02215-3904. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Komyati, Stephen can be contacted via phone (617) 421-1122.

Contact Information

Primary practice address
133 Brookline Ave Boston MA 02215-3904
Phone: (617) 421-1122
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 18568 Massachusetts

Profile Details

NPI number 1073575726
LBN Legal business name Komyati, Stephen
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2006
Last updated Apr 7th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073575726 NPPES
Massachusetts Other X08000 BCBS - DENTAL
Massachusetts Other PD197 BCBS - DENTAL

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