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NPI Code Detail

MEDICARE: DR. SUNEEL C. KANDRU DDS

MEDICARE: DR. SUNEEL C. KANDRU DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223E0200XEndodonticsDL15572MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
19760OTHERDENTAL LICENSE

General Provider Information

NPI Number : 1801076690
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUNEEL C. KANDRU DDS
Provider Business Mailing Address
First Line : 326 NICHOLS ROAD
Second Line :
City : FITCHBURG
State : MA
Zip : 01420
Country : US
Telephone Number : 978-878-8100
Fax Number : 978-878-8326
Provider Business Practice Location Address
First Line : 45 DIMOCK ST
Second Line :
City : ROXBURY
State : MA
Zip : 02119-1208
Country : US
Telephone Number : 617-442-8800
Fax Number : 617-541-0950
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2007
Last Update Date : 05/13/2026

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