Healthcare Provider Details

I. General information

NPI: 1114871704
Provider Name (Legal Business Name): PATRICIA MOORADIAN RDH, OMT, CH-OSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 COUGHLIN RD
LITTLETON MA
01460-2108
US

IV. Provider business mailing address

11 COUGHLIN RD
LITTLETON MA
01460-2108
US

V. Phone/Fax

Practice location:
  • Phone: 978-580-7490
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH87489
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: