Healthcare Provider Details

I. General information

NPI: 1013259175
Provider Name (Legal Business Name): DENNIS B. THAPA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2013
Last Update Date: 07/21/2022
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789 CENTRAL AVE
DOVER NH
03820-2526
US

IV. Provider business mailing address

PO BOX 412503
BOSTON MA
02241-2503
US

V. Phone/Fax

Practice location:
  • Phone: 603-609-6819
  • Fax: 603-609-6821
Mailing address:
  • Phone: 603-609-6819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number270280
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number18888
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: