Provider Demographics
NPI:1467654988
Name:NANDITA KAPOOR, DMD, PC
Entity Type:Organization
Organization Name:NANDITA KAPOOR, DMD, PC
Other - Org Name:NEEDHAM DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NANDITA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPOOR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-449-6644
Mailing Address - Street 1:302 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2411
Mailing Address - Country:US
Mailing Address - Phone:781-449-6644
Mailing Address - Fax:
Practice Address - Street 1:302 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2411
Practice Address - Country:US
Practice Address - Phone:781-449-6644
Practice Address - Fax:781-444-3176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty