Provider Demographics
NPI:1144210824
Name:QUADERI, SERAJUS SALEKIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SERAJUS
Middle Name:SALEKIN
Last Name:QUADERI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PROGRESS ST
Mailing Address - Street 2:SUITE #101
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1102
Mailing Address - Country:US
Mailing Address - Phone:908-754-5252
Mailing Address - Fax:908-754-6663
Practice Address - Street 1:3 PROGRESS ST
Practice Address - Street 2:SUITE #101
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1102
Practice Address - Country:US
Practice Address - Phone:908-754-5252
Practice Address - Fax:908-754-6663
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ17788122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6792103Medicaid