Provider Demographics
NPI:1164031613
Name:TSAI, REBECCA (DMD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:TSAI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BROOKLINE AVE UNIT 512
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-3952
Mailing Address - Country:US
Mailing Address - Phone:949-981-1046
Mailing Address - Fax:
Practice Address - Street 1:73 LEXINGTON ST STE 204
Practice Address - Street 2:
Practice Address - City:AUBURNDALE
Practice Address - State:MA
Practice Address - Zip Code:02466-1384
Practice Address - Country:US
Practice Address - Phone:617-244-5020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18587631223G0001X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice