MEDICARE: DR. JOHN DENG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	1021867	MA
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1851041479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN DENG MD

Provider Business Mailing Address
First Line	:	330 BROOKLINE AVE
Second Line	:	SPAN2
City	:	BOSTON
State	:	MA
Zip	:	02215-5400
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 BROOKLINE AVE # SPAN221
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02215-5491
Country	:	US
Telephone Number	:	617-754-4677
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2022
Last Update Date	:	01/17/2026

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Directions to “ DR. JOHN DENG MD” Practice Location

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