Healthcare Provider Details

I. General information

NPI: 1811099666
Provider Name (Legal Business Name): KAMACHI & KAMACHI DMD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 11/04/2021
Certification Date: 11/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 BOYLSTON ST FL 2
BOSTON MA
02199-1900
US

IV. Provider business mailing address

27 PIER 7
CHARLESTOWN MA
02129-4226
US

V. Phone/Fax

Practice location:
  • Phone: 617-721-6188
  • Fax:
Mailing address:
  • Phone: 617-721-6188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number20427
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number20426
License Number StateMA

VIII. Authorized Official

Name: DR. KUMIKO KAMACHI
Title or Position: TREASURER
Credential: DMD
Phone: 617-266-4242