Healthcare Provider Details

I. General information

NPI: 1164157855
Provider Name (Legal Business Name): MS. ANAHAT KHEHRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2022
Last Update Date: 10/14/2022
Certification Date: 10/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HARVARD DENTAL CENTER 188 LONGWOOD AVE.
BOSTON MA
02115
US

IV. Provider business mailing address

HARVARD DENTAL CENTER 188 LONGWOOD AVE.
BOSTON MA
02115
US

V. Phone/Fax

Practice location:
  • Phone: 617-432-1434
  • Fax: 617-432-4258
Mailing address:
  • Phone: 617-432-1434
  • Fax: 617-432-4258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDL15309
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: