Provider Demographics
NPI:1225209745
Name:PANDEY, ABHA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ABHA
Middle Name:
Last Name:PANDEY
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 1:110 N STATE ROAD 267
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-8475
Mailing Address - Country:US
Mailing Address - Phone:317-272-7206
Mailing Address - Fax:
Practice Address - Street 1:110 N STATE ROAD 267
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-8475
Practice Address - Country:US
Practice Address - Phone:317-272-7206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011055A1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry