Provider Demographics
NPI:1033248463
Name:SARDANA, AJIT KUMAR (BDS(ORTHODONTIST))
Entity Type:Individual
Prefix:DR
First Name:AJIT
Middle Name:KUMAR
Last Name:SARDANA
Suffix:
Gender:M
Credentials:BDS(ORTHODONTIST)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:538 WESTERN HWY
Mailing Address - Street 2:
Mailing Address - City:BLAUVELT
Mailing Address - State:NY
Mailing Address - Zip Code:10913-2015
Mailing Address - Country:US
Mailing Address - Phone:845-507-3617
Mailing Address - Fax:
Practice Address - Street 1:538 WESTERN HWY
Practice Address - Street 2:
Practice Address - City:BLAUVELT
Practice Address - State:NY
Practice Address - Zip Code:10913-2015
Practice Address - Country:US
Practice Address - Phone:845-507-3617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0380211223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics