Healthcare Provider Details

I. General information

NPI: 1578428850
Provider Name (Legal Business Name): HAMPSHIRE MEADOW ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 RUSSELL ST STE 18
HADLEY MA
01035-5907
US

IV. Provider business mailing address

207 RUSSELL ST STE 18
HADLEY MA
01035-5907
US

V. Phone/Fax

Practice location:
  • Phone: 413-387-4636
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. CYRUS SAFIZADEH
Title or Position: CEO
Credential: DMD
Phone: 413-387-4636