# RIVERBEND ORAL AND MAXILLOFACIAL SURGERY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215893243
- **Authorized official:** DR. ANJU NELLISSERY DMD, MD (PRESIDENT)
- **Authorized official phone:** (860) 335-0168

## Contact information

- **Practice address:** 1066 GRANBY RD, CHICOPEE, MA 01020-1539
- **Practice address phone:** (413) 534-4400
- **Mailing address:** 1066 GRANBY RD, CHICOPEE, MA 01020-1539
- **Mailing address phone:** (413) 534-4400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | Yes |

## Other

- **Enumeration date:** 01/03/2026
- **Last updated:** 01/03/2026