Healthcare Provider Details

I. General information

NPI: 1952249476
Provider Name (Legal Business Name): TAMANNABEN PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 JACKSON ST UNIT B
METHUEN MA
01844-5068
US

IV. Provider business mailing address

71 HOSMER ST
ACTON MA
01720-5408
US

V. Phone/Fax

Practice location:
  • Phone: 978-258-2377
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN10001345
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: