Healthcare Provider Details

I. General information

NPI: 1639099013
Provider Name (Legal Business Name): LEXINGTON DENTAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 BEDFORD ST STE 110
LEXINGTON MA
02420-4550
US

IV. Provider business mailing address

57 BEDFORD ST STE 110
LEXINGTON MA
02420-4550
US

V. Phone/Fax

Practice location:
  • Phone: 617-953-5221
  • Fax:
Mailing address:
  • Phone: 617-953-5221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: MR. VIK KAPOOR
Title or Position: MANAGER
Credential:
Phone: 617-953-5221