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Dr. Jeremiah David Penberthy , DMD

Dentist - General Practice β€’ Boston, MA

Active NPI 1386431310 Individual Practitioner Male Practitioner
Practice location in NPPES

635 Albany St
Boston, MA 021183550

Call 6173588300 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

635 Albany St

Boston, MA 021183550

Telephone 6173588300
Other Listings in Public Data

NPPES lists 3 distinct additional practice-address records in East Boston, MA; Lynn, MA; Revere, MA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2025

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Boston and Massachusetts

392 active clinicians are listed under Dentist - General Practice with a practice address in Boston, MA (3,491 in Massachusetts).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Boston

0% of these 392 clinicians have the CMS telehealth indicator.

0.5% of these 392 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-02-09
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

License # reported to NPPES MA DN10000823

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

License # reported to NPPES MA DN10000823

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Massachusetts Board of Registration in Medicine.
Look Up on State Board Site

Secondary Practice Locations

140 Union St Ste 303

Lynn, MA 019011326

Phone: 7815924438

999 Saratoga St

East Boston, MA 021281238

Phone: 6175692761

123 Revere St

Revere, MA 021514439

Phone: 6173777924

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

5 listed
NPI 1063112316

DMDBDS

Yu-Ting Chan

Dentist - Periodontics

NPI 1013792217
NPI 1013698901
NPI 1063067163
Dr. Anoush Longerstaey , DMD

Dentist - Oral and Maxillofacial Surgery

NPI 1033841564

Doctor of Dental Medicine

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location February 05, 2026

Registered at 635 ALBANY ST, BOSTON, MA 021183550 (Tel: 6173588300)

πŸ“
Updated Business Mailing Address February 05, 2026

Registered at 167 WINTHROP SHORE DR UNIT 2, WINTHROP, MA 021521247 (Tel: 2087711172)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 05, 2026

Student in an Organized Health Care Education/Training Program (license number reported to NPPES: MA DN10000823)

βœ…
NPI Profile Active April 23, 2025

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 23, 2025

Registered at 3450 LACEY RD, DOWNERS GROVE, IL 605155430 (Tel: 6307434500)

πŸ“
Business Mailing Address (Initial Record) April 23, 2025

Registered at 406 W AVERY ST, ELMHURST, IL 601264910 (Tel: 2087711172)

πŸ‘€
Provider Name / Credentials (Initial Record) April 23, 2025

Recorded as JEREMIAH PENBERTHY, DMD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 23, 2025

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration April 23, 2025

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1386431310
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 23, 2025
Last Update: February 09, 2026
Sole Proprietor: No

Other Dentist - General Practices in Boston

All Dentist - General Practices in Boston

Mailing Address

167 Winthrop Shore Dr Unit 2

Winthrop, MA 021521247

Phone: 2087711172

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.