Provider Demographics
NPI:1205368768
Name:AHUJA DENTAL GROUP INC
Entity Type:Organization
Organization Name:AHUJA DENTAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:
Authorized Official - First Name:ARSHJOT
Authorized Official - Middle Name:
Authorized Official - Last Name:AHUJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-456-5089
Mailing Address - Street 1:6167 BRISTOL PKWY
Mailing Address - Street 2:SUTIE 300
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6610
Mailing Address - Country:US
Mailing Address - Phone:909-456-5089
Mailing Address - Fax:
Practice Address - Street 1:6167 BRISTOL PKWY
Practice Address - Street 2:SUTIE 300
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6610
Practice Address - Country:US
Practice Address - Phone:909-456-5089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57141122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty