Individual
KIPA SHAKYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
30 MAIN ST, MEDFORD, MA 02155-7102
(781) 391-2440
Mailing address
3920 MYSTIC VALLEY PKWY APT 118, MEDFORD, MA 02155-6900
(617) 480-2062
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN10000846
MA
Other
Enumeration date
05/23/2025
Last updated
09/08/2025
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