Provider Demographics
NPI:1255361424
Name:LYNN DENTAL HEALTH INC
Entity type:Organization
Organization Name:LYNN DENTAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEYASRI
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNARAJASINGAM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-595-2552
Mailing Address - Street 1:10 KIRTLAND ST
Mailing Address - Street 2:LYNN DENTAL HEALTH
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01905-1821
Mailing Address - Country:US
Mailing Address - Phone:781-595-2552
Mailing Address - Fax:781-593-0730
Practice Address - Street 1:10 KIRTLAND ST
Practice Address - Street 2:LYNN DENTAL HEALTH
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01905-1821
Practice Address - Country:US
Practice Address - Phone:781-595-2552
Practice Address - Fax:781-593-0730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9776524Medicaid