Healthcare Provider Details

I. General information

NPI: 1700792652
Provider Name (Legal Business Name): LOTUS DENTAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 WINSOR ST STE 102
LUDLOW MA
01056-3470
US

IV. Provider business mailing address

77 WINSOR ST STE 102
LUDLOW MA
01056-3470
US

V. Phone/Fax

Practice location:
  • Phone: 413-636-5134
  • Fax: 413-583-5124
Mailing address:
  • Phone: 413-636-5134
  • Fax: 413-583-5124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. BINCA WARREN
Title or Position: DMD/OWNER
Credential: DMD
Phone: 413-636-5134