Healthcare Provider Details

I. General information

NPI: 1629900253
Provider Name (Legal Business Name): CREDIMEDLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 SPRING ST
CAMBRIDGE MA
02141-1815
US

IV. Provider business mailing address

99 SPRING ST
CAMBRIDGE MA
02141-1815
US

V. Phone/Fax

Practice location:
  • Phone: 617-803-3831
  • Fax: 617-749-4550
Mailing address:
  • Phone: 617-803-3831
  • Fax: 617-749-4550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: JUAN LUIS SANCHEZ
Title or Position: MANAGING MEMBER AND FOUNDER
Credential:
Phone: 617-803-3831