Healthcare Provider Details

I. General information

NPI: 1891655064
Provider Name (Legal Business Name): MVDENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 BRIDGE ST
DRACUT MA
01826-2618
US

IV. Provider business mailing address

1651 BRIDGE ST
DRACUT MA
01826-2618
US

V. Phone/Fax

Practice location:
  • Phone: 716-939-4818
  • Fax:
Mailing address:
  • Phone: 716-939-4818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUNIT JAIN
Title or Position: OWNER
Credential: DDS
Phone: 716-939-4818