Healthcare Provider Details

I. General information

NPI: 1477465854
Provider Name (Legal Business Name): HELI BHARGAVKUMAR TRIVEDI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CENTRE ST
ROSLINDALE MA
02131-1011
US

IV. Provider business mailing address

635 ALBANY ST
BOSTON MA
02118-3550
US

V. Phone/Fax

Practice location:
  • Phone: 617-363-8234
  • Fax:
Mailing address:
  • Phone: 617-358-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDL101666
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: