DR. ERIC R GHEEWALLA (NPI# 1194721795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194721795 |
| Entity Type | Individual |
| Full Name | DR. ERIC R GHEEWALLA |
| Credential | DMD |
| Practice Address |
82 Forest St Medford MA 02155-3130 |
| Practice Telephone | 7813961980 |
| Practice Fax Number | 7813964224 |
| Mailing Telephone | 7813961980 |
| Mailing Fax Number | 7813964224 |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
18335 | MA | Dental Providers |
| Street Address |
82 FOREST ST |
| City | MEDFORD |
| State | MA |
| Zip Code | 02155-3130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548287220 | Suburban Diagnostic Labs | Radiologic Technologist | 82 Forest St, Medford, MA 02155-3105 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679113922 | Elena Chapman | Nurse Practitioner | 293 Salem St 4, Medford, MA 02155 | 2020-01-14 |
| 1922658830 | Michelle Anne Zona | Counselor | 100 George Hassett Dr, Medford, MA 02155 | 2019-09-13 |
| 1487138509 | Dava Davainis | Social Worker | 76 Newbern Avenue, Apt. 1, Medford, MA 02155 | 2018-09-25 |
| 1265915128 | Erin Roberts | Counselor | Medford Public Schools, 3002 Mystic Valley Pkwy, Medford, MA 02155 | 2018-09-07 |
| 1871075739 | Janice Madeline Cole | Social Worker | 3820 Mystic Valley Pkwy Unit 805, Medford, MA 02155 | 2018-09-06 |
| 1447732573 | Mystick Women's Health, Inc. | Obstetrics & Gynecology | 13 Bradlee Road, Medford, MA 02155 | 2018-09-05 |
| 1144713090 | Laura Rogers | Psychologist | 203 Paige Hall, 12 Upper Campus Road, Medford, MA 02155 | 2018-06-14 |
| 1871086694 | Shuo Yang | Dentist | 8 9th St Apt 310, Medford, MA 02155 | 2018-06-07 |
| 1891287108 | Xuhua Qin | Psychologist | 120 Curtis Street, Medford, MA 02155 | 2018-06-01 |
| 1568953529 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 471 Salem St, Medford, MA 02155 | 2018-05-25 |
| Find all providers in zip 02155 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003381914 | Keyan Botsford | Dentist | 1625 E Mcandrews Rd Ste B, Medford, OR 97504-5334 | 2018-10-06 |
| 1184939621 | Megan Janee Baker | Dentist | 1429 Center Dr Ste 104, Medford, OR 97501-7993 | 2010-08-09 |
| 1235259417 | Joy Elizabeth Kasparian Federico | Dentist | 80 High Street, Suite #2, Medford, MA 02155 | 2007-03-30 |
| 1760509756 | Edwin Wridge Bennion | Dentist | 725 Golf View Dr, Medford, OR 97504-9643 | 2007-03-23 |
| 1679607105 | Leon S Klempner | Dentist | 1645 Route 112 Ste B, Medford, NY 11763-3635 | 2007-03-15 |
| 1215042122 | Darren B. Ravassipour | Dentist | 3180 State St Ste 102, Medford, OR 97504-8493 | 2006-08-20 |
| 1265445647 | David A. Wang | Dentist | 537 Murphy Rd, Suite B, Medford, OR 97504-8187 | 2006-08-15 |
| 1740209832 | Edward V. Shagam | Dentist | 686 Stokes Rd, Medford, NJ 08055-2909 | 2006-07-19 |
| 1316915788 | David M. Petrarca, Dds & Sungyon Bang, Dmd, P.C. | Dentist | 80 High St, Medford, MA 02155-3813 | 2006-03-10 |
| 1295726388 | Barry M Katzen | Dentist | 2937 Siskiyou Blvd, Medford, OR 97504-8100 | 2005-10-29 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.