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NPI Code Detail

MEDICARE: NA TIAN DMD, PH.D.

MEDICARE:   NA  TIAN  DMD, PH.D.
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistDN1858483MA

General Provider Information

NPI Number : 1801444922
Entity Type Code : Individual
Provider Name (Legal Business Name) : NA TIAN DMD, PH.D.
Provider Business Mailing Address
First Line : 150 E MAIN ST UNIT 28
Second Line :
City : WESTBOROUGH
State : MA
Zip : 01581-8101
Country : US
Telephone Number : 617-415-8012
Fax Number :
Provider Business Practice Location Address
First Line : 2 WESLEYAN TER
Second Line :
City : SHREWSBURY
State : MA
Zip : 01545-2933
Country : US
Telephone Number : 508-435-3368
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2019
Last Update Date : 04/07/2026

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