Healthcare Provider Details

I. General information

NPI: 1093646044
Provider Name (Legal Business Name): SMILE TEAM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 WASHINGTON ST STE 302
DEDHAM MA
02026-1862
US

IV. Provider business mailing address

347 WASHINGTON ST STE 302
DEDHAM MA
02026-1862
US

V. Phone/Fax

Practice location:
  • Phone: 781-329-4545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: LULJETA ISEDISHA
Title or Position: MANAGER
Credential: DMD
Phone: 617-651-1640