MEDICARE: LYNN FAMILY DENTAL AND ORTHODONTICS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	1223G0001X	General Practice Dentistry
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry
3	122300000X	Dentist

General Provider Information

NPI Number	:	1700744034
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LYNN FAMILY DENTAL AND ORTHODONTICS PC

Provider Business Mailing Address
First Line	:	234 COPELAND ST STE 330
Second Line	:
City	:	QUINCY
State	:	MA
Zip	:	02169-4082
Country	:	US
Telephone Number	:	617-401-8298
Fax Number	:	617-997-0030

Provider Business Practice Location Address
First Line	:	234 COPELAND ST STE 330
Second Line	:
City	:	QUINCY
State	:	MA
Zip	:	02169-4082
Country	:	US
Telephone Number	:	617-401-8298
Fax Number	:	617-997-0030

Authorized Official
Title or Position	:	OWNER
Name	:	NEETU BANSAL
Credential	:	DMD
Telephone Number	:	617-401-8298

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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