Healthcare Provider Details

I. General information

NPI: 1790602258
Provider Name (Legal Business Name): LOWELL ENDODONTICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

45 PINEWOOD AVE
SUDBURY MA
01776-1584
US

IV. Provider business mailing address

45 PINEWOOD AVE
SUDBURY MA
01776-1584
US

V. Phone/Fax

Practice location:
  • Phone: 978-460-4048
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: VANESSA THAI
Title or Position: CEO
Credential: DMD
Phone: 978-460-4048