Healthcare Provider Details

I. General information

NPI: 1023818804
Provider Name (Legal Business Name): REHANA BOHRA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2025
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 BOYLSTON ST
BOSTON MA
02215-4302
US

IV. Provider business mailing address

180 BROOKLINE AVE UNIT 1032
BOSTON MA
02215-3928
US

V. Phone/Fax

Practice location:
  • Phone: 617-267-0900
  • Fax:
Mailing address:
  • Phone: 248-770-8316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN10001228
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: