Provider Demographics
NPI:1932760311
Name:MARIPURI, SWAITHA S (DMD)
Entity Type:Individual
Prefix:
First Name:SWAITHA
Middle Name:S
Last Name:MARIPURI
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 1:41 UPTON ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-1609
Mailing Address - Country:US
Mailing Address - Phone:603-479-7929
Mailing Address - Fax:
Practice Address - Street 1:380 MERRIMACK ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-5870
Practice Address - Country:US
Practice Address - Phone:978-681-7740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1858315122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist