Healthcare Provider Details

I. General information

NPI: 1427369883
Provider Name (Legal Business Name): NIDHI AGARWAL DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2010
Last Update Date: 05/25/2021
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 WILLOW WOODS DR
SHREWSBURY MA
01545-6043
US

IV. Provider business mailing address

9 WILLOW WOODS DR
SHREWSBURY MA
01545-6043
US

V. Phone/Fax

Practice location:
  • Phone: 857-284-6358
  • Fax:
Mailing address:
  • Phone: 61-730-6127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number019028384
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1856537
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDN1856537
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: