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LOWELL FAMILY DENTAL PRACTICE PC NPI 1588790067


NPI Information

NPI: 1588790067
Provider Name: LOWELL FAMILY DENTAL PRACTICE PC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
133 MARKET STREET
LOWELL, MA
ZIP 01852
Phone: (978) 458-1179
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LOWELL FAMILY DENTAL PRACTICE PC is a general practice dentist in Lowell, MA. The provider is 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. LOWELL FAMILY DENTAL PRACTICE PC NPI is 1588790067. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

133 MARKET STREET
LOWELL, MA
ZIP 01852-808
Phone: (978) 458-1179
Fax: (978) 805-1415

The provider's authorized official is Konstantin V Amirzadov .
The authorized official title is President and has the following contact phone number (978) 458-1179.

The enumeration date for this NPI number is 2/26/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice21536MASSACHUSETTSNo
21223G0001XDentistGeneral Practice21444MASSACHUSETTSNo
31223G0001XDentistGeneral Practice18197MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1X11619OTHERMASSACHUSETTSBLUE CROSS BLUE SHIELD
29727230MEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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