Healthcare Provider Details

I. General information

NPI: 1457564007
Provider Name (Legal Business Name): TODAYS DENTAL OF BOXBOROUGH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 MASSACHUSETTS AVE
BOXBOROUGH MA
01719-1528
US

IV. Provider business mailing address

629 MASSACHUSETTS AVE
BOXBOROUGH MA
01719-1528
US

V. Phone/Fax

Practice location:
  • Phone: 978-263-8950
  • Fax: 978-263-1404
Mailing address:
  • Phone: 978-263-8950
  • Fax: 978-263-1404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number19937
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number20541
License Number StateMA

VIII. Authorized Official

Name: DR. VENIAMIN KALMANOVICH
Title or Position: DENTIST-OWNER
Credential:
Phone: 978-263-8950