MY DENTAL LLC (NPI# 1366722100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366722100 |
| Entity Type | Organization |
| Organization Name | MY DENTAL LLC |
| Practice Address |
314 Moody St Suite B Waltham MA 02453-5202 |
| Mailing Address |
184 Kennedy Dr Apt 10 Malden MA 02148-3402 |
| Practice Telephone | 7402158549 |
| Mailing Telephone | 7402158549 |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2011-08-24 |
| Authorized Official Name | DR. SRINIVAS DESANEEDI (DENTIST) |
| Authorized Official Telephone | 7402158549 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
22184 | MA | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | MY DENTAL LLC | 525 Park Ave N # B, Renton, WA 98057-5522 |
| Massachusetts Corporations | MY DENTAL LLC | 314 Moody St, Suite B, Waltham, MA 02453 |
| Street Address |
314 MOODY ST SUITE B |
| City | WALTHAM |
| State | MA |
| Zip Code | 02453-5202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433549 | Ruchieka Vij | Dentist | 314 Moody St, Waltham, MA 02453-5202 | 2020-09-29 |
| 1326558750 | Tripti Gupta | Dentist | 314 Moody St, Waltham, MA 02453-5202 | 2017-10-12 |
| 1669840419 | Neha Sood | Dentist | 314 Moody St, Waltham, MA 02453-5202 | 2015-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811595770 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 66 Seyon St, Waltham, MA 02453 | 2020-10-13 |
| 1679040935 | Elsa L. Lichman | Social Worker | 52 Derby Street, Waltham, MA 02453 | 2018-10-25 |
| 1760957468 | Sherry Leigh Miller | Counselor | C/o Children's Charter, 77 Rumford Ave, Waltham, MA 02453 | 2018-10-09 |
| 1639644651 | Leo V Sarkissian | Social Worker | The Arc of Massachusetts, 217 South Street, Waltham, MA 02453 | 2018-10-05 |
| 1629569512 | Abaytum Investments Inc | Home Health | 24 Crescent Street, Suite 104, Waltham, MA 02453 | 2018-05-25 |
| 1225542970 | Mikayla E Culpo | Nurse Practitioner | 9 Hope Ave Fl Bch4, Waltham, MA 02453 | 2017-11-16 |
| 1568975449 | Twyla Atherna Everett | Massage Therapist | 212 Calvary St, Waltham, MA 02453 | 2017-11-14 |
| 1407369382 | Eli Miller | Counselor | 431 River Street, Suite 1, Waltham, MA 02453 | 2017-11-14 |
| 1396263927 | Jill Zaricor | Student in an Organized Health Care Education/Training Program | 77 Rumford Ave C/o Children's Charter, Waltham, MA 02453 | 2017-09-04 |
| 1538683008 | Michael Scaduto | Physical Therapist | 110-1 Clematis Ave, Waltham, MA 02453 | 2017-07-27 |
| Find all providers in zip 02453 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437621224 | Aesthetic Smile Reconstruction PC | Clinic/Center | 75 3rd Ave Ste 1b, Waltham, MA 02451-7549 | 2018-12-18 |
| 1770797698 | Trustees of Tufts College | Clinic/Center | Tdf Community Program, 200 Trapelo Rd, Waltham, MA 02452 | 2007-05-09 |
| 1558631432 | Gentle Dental Waltham | Clinic/Center | 879 Main St, Waltham, MA 02451-7414 | 2012-01-09 |
| 1396053542 | Axis Orthodontics PC | Clinic/Center | 980 Main St, Waltham, MA 02451-7404 | 2010-09-22 |
| 1871719104 | Trustees of Tufts University | Clinic/Center | 200 Trapelo Rd, Waltham, MA 02452-6332 | 2007-04-17 |
| 1295959849 | Trustees of Tufts University | Clinic/Center | 200 Trapelo Rd, Waltham, MA 02452-6332 | 2007-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265771 | Sidhu Family Dental LLC | Clinic/Center | 15 West St Ste 101, Douglas, MA 01516-2160 | 2020-11-04 |
| 1205436276 | The Nurture Frenectomy Center | Clinic/Center | 200 Elm St Ste 1, Pittsfield, MA 01201-6551 | 2020-10-29 |
| 1417557463 | Marva Khalid Dentistry PC | Clinic/Center | 105 Chestnut St Ste 25, Needham, MA 02492-2520 | 2020-10-29 |
| 1417555855 | Gardner Smiles Pllc | Clinic/Center | 356 Timpany Blvd, Gardner, MA 01440-5200 | 2020-10-16 |
| 1326646399 | Restoration Smiles, P.C. | Clinic/Center | 2 Coolidge St Ste 202, Hudson, MA 01749-1459 | 2020-10-13 |
| 1295333573 | Brian P. Ganley, Dmd, PC | Clinic/Center | 134 Main St Unit 1c, Groton, MA 01450-1375 | 2020-10-09 |
| 1619583168 | Newton Wellesley Dental Group LLC | Clinic/Center | 447 Centre Street, Same, Newton, MA 02458 | 2020-09-21 |
| 1114533866 | Cdg Back Bay LLC | Clinic/Center | 400 Commonwealth Ave 3rd Floor, Boston, MA 02215 | 2020-09-18 |
| 1831703099 | Beacon Dental Health PC | Clinic/Center | 80 Washington St Bldg B, Norwell, MA 02061-1740 | 2020-09-04 |
| 1487267282 | Shoe City Family Dental PC | Clinic/Center | 103 Merrimack St, Haverhill, MA 01830-6208 | 2020-08-31 |
| Find all providers with the same taxonomy | ||||
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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.