Provider Demographics
NPI:1003993668
Name:CHOPRA, ANITA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:
Last Name:CHOPRA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 DUNCANNON AVENUE #2
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2141 BOSTON ROAD
Practice Address - Street 2:NORTHEAST DENTAL
Practice Address - City:WILBRAHAM
Practice Address - State:MA
Practice Address - Zip Code:01095
Practice Address - Country:US
Practice Address - Phone:413-599-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT2126122300000X
CT8692122300000X
MA19646122300000X
ME3688122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME0282839Medicare ID - Type Unspecified