OrganizationActive
My Dental LLC
NPI 1366722100 · Dental Clinic/Center · Waltham, MA
Provider details
- NPI number
- 1366722100
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Srinivas Desaneedi, Dentist(740) 215-8549
- License
- 22184 (MA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(81/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
314 Moody St
Suite B
Waltham, MA 02453-5202
Phone: (740) 215-8549
Street-level locationGet directions
Mailing address
184 Kennedy Dr
Malden, MA 02148-3402
Registry dates
- Enumerated
- 2011-08-24
- Last updated
- 2011-08-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.