Provider Demographics
NPI:1497360572
Name:RAMESH, NIVEDHITHA (DMD)
Entity Type:Individual
Prefix:DR
First Name:NIVEDHITHA
Middle Name:
Last Name:RAMESH
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 1:42 8TH ST APT 1307
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-4215
Mailing Address - Country:US
Mailing Address - Phone:774-258-1336
Mailing Address - Fax:
Practice Address - Street 1:946 MAIN ST
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-1912
Practice Address - Country:US
Practice Address - Phone:781-665-4446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18587951223G0001X
MA18587951223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No1223G0001XDental ProvidersDentistGeneral Practice