Provider Demographics
NPI:1144238015
Name:TRIVEDI, NIRALI (DDS)
Entity Type:Individual
Prefix:MRS
First Name:NIRALI
Middle Name:
Last Name:TRIVEDI
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 1:7 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08835
Mailing Address - Country:US
Mailing Address - Phone:908-722-6500
Mailing Address - Fax:908-722-7206
Practice Address - Street 1:7 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08835
Practice Address - Country:US
Practice Address - Phone:908-722-6500
Practice Address - Fax:908-722-7206
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1020471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice