Provider Demographics
NPI:1275225583
Name:NEGREIROS, WILLIAM MATTHEW (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MATTHEW
Last Name:NEGREIROS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 WALTHAM ST STE 202
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-8019
Mailing Address - Country:US
Mailing Address - Phone:781-861-7645
Mailing Address - Fax:
Practice Address - Street 1:922 WALTHAM ST STE 202
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-8019
Practice Address - Country:US
Practice Address - Phone:781-861-7645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MADN1859874122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program