Healthcare Provider Details

I. General information

NPI: 1215500988
Provider Name (Legal Business Name): SHREYA MOHAN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2021
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 TURNPIKE ST STE G1
NORTH ANDOVER MA
01845-5038
US

IV. Provider business mailing address

42 WELLMAN ST APT 110
LOWELL MA
01851-5163
US

V. Phone/Fax

Practice location:
  • Phone: 978-983-8044
  • Fax:
Mailing address:
  • Phone: 978-319-0262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1859103
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: