Provider Demographics
NPI:1134295140
Name:BAHAWDORY, ARIEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ARIEN
Middle Name:
Last Name:BAHAWDORY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-2306
Mailing Address - Country:US
Mailing Address - Phone:201-385-5080
Mailing Address - Fax:
Practice Address - Street 1:85 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-2306
Practice Address - Country:US
Practice Address - Phone:201-385-5080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02199200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist