Healthcare Provider Details

I. General information

NPI: 1275028516
Provider Name (Legal Business Name): TIMOTHY REICHHELD DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2018
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 LITTLETON RD
WESTFORD MA
01886-3109
US

IV. Provider business mailing address

111 W 8TH ST APT Q
BOSTON MA
02127-2566
US

V. Phone/Fax

Practice location:
  • Phone: 978-692-5799
  • Fax:
Mailing address:
  • Phone: 603-769-0765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN1858674
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: