Healthcare Provider Details

I. General information

NPI: 1174434997
Provider Name (Legal Business Name): DR. TAMIRES MOREIRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 MILL ST
LEOMINSTER MA
01453-3592
US

IV. Provider business mailing address

16 PINE ST # 2
MEDWAY MA
02053-1132
US

V. Phone/Fax

Practice location:
  • Phone: 978-878-8100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: