Healthcare Provider Details

I. General information

NPI: 1780442483
Provider Name (Legal Business Name): ANH DAM DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2024
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 BROADWAY APT 1C
CHELSEA MA
02150-2285
US

IV. Provider business mailing address

220 OLIVER ST
MALDEN MA
02148-4610
US

V. Phone/Fax

Practice location:
  • Phone: 617-889-5437
  • Fax:
Mailing address:
  • Phone: 781-813-9464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDN10001309
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: