Provider Demographics
NPI:1134701568
Name:MARWAH, SIMRAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SIMRAN
Middle Name:
Last Name:MARWAH
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 1:3425 ERIE BLVD E
Mailing Address - Street 2:
Mailing Address - City:DE WITT
Mailing Address - State:NY
Mailing Address - Zip Code:13214-1635
Mailing Address - Country:US
Mailing Address - Phone:315-726-3439
Mailing Address - Fax:
Practice Address - Street 1:3425 ERIE BLVD E
Practice Address - Street 2:
Practice Address - City:DE WITT
Practice Address - State:NY
Practice Address - Zip Code:13214-1635
Practice Address - Country:US
Practice Address - Phone:315-726-3439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-26
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY062472122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program