Healthcare Provider Details

I. General information

NPI: 1962527150
Provider Name (Legal Business Name): SUMEET SAXENA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 06/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 RUSSELL ST
HADLEY MA
01035-9533
US

IV. Provider business mailing address

13224 PATRIOT WAY
WEST GREENWICH RI
02817-6012
US

V. Phone/Fax

Practice location:
  • Phone: 413-584-6275
  • Fax:
Mailing address:
  • Phone: 973-687-5542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS036954
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN03029
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN22332
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: