Provider Demographics
NPI:1033527841
Name:JAIN, ANUSHRI (DDS)
Entity Type:Individual
Prefix:
First Name:ANUSHRI
Middle Name:
Last Name:JAIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 HAYESTOWN RD
Mailing Address - Street 2:1302
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-4996
Mailing Address - Country:US
Mailing Address - Phone:917-331-5405
Mailing Address - Fax:
Practice Address - Street 1:54 MAIN ST
Practice Address - Street 2:SUITE F
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-3009
Practice Address - Country:US
Practice Address - Phone:203-790-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-24
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0113441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice