Healthcare Provider Details

I. General information

NPI: 1467766600
Provider Name (Legal Business Name): WESTERN MASS HOSPITAL DENTAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 EAST MOUNTAIN RD
WESTFIELD MA
01085
US

IV. Provider business mailing address

PO BOX 6260 230 MAPLE ST
HOLYOKE MA
01040-6260
US

V. Phone/Fax

Practice location:
  • Phone: 413-420-2200
  • Fax:
Mailing address:
  • Phone: 413-420-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number4118
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEJANDRO ESPARZA PEREZ
Title or Position: CEO
Credential: MD
Phone: 413-420-2110