Healthcare Provider Details

I. General information

NPI: 1063320984
Provider Name (Legal Business Name): CLIFF RIDGE OF MASSACHUSETTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 BROADWAY STE B
METHUEN MA
01844-2062
US

IV. Provider business mailing address

413 BROADWAY STE B
METHUEN MA
01844-2062
US

V. Phone/Fax

Practice location:
  • Phone: 978-425-1496
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MONA DANESHI
Title or Position: OWNER
Credential:
Phone: 631-206-5944