Provider Demographics
NPI:1578627535
Name:KAVETI, KALPANA (DMD)
Entity Type:Individual
Prefix:
First Name:KALPANA
Middle Name:
Last Name:KAVETI
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 1:347 MASSACHUSETTS AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-6740
Mailing Address - Country:US
Mailing Address - Phone:781-643-7050
Mailing Address - Fax:781-643-0188
Practice Address - Street 1:347 MASSACHUSETTS AVE STE 1
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-6740
Practice Address - Country:US
Practice Address - Phone:781-643-7050
Practice Address - Fax:781-643-0188
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN204281223G0001X
MA20428122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice