Provider Demographics
NPI:1205400470
Name:AJS DENTAL LLC
Entity Type:Organization
Organization Name:AJS DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SWETHA
Authorized Official - Middle Name:REDDY
Authorized Official - Last Name:PAKANATI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-991-0844
Mailing Address - Street 1:524 LIPPINCOTT DR STE B
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4804
Mailing Address - Country:US
Mailing Address - Phone:856-596-3200
Mailing Address - Fax:856-596-3256
Practice Address - Street 1:524 LIPPINCOTT DR STE B
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-4804
Practice Address - Country:US
Practice Address - Phone:856-596-3200
Practice Address - Fax:856-596-3256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental