Provider Demographics
NPI:1225362916
Name:RATHOD, HITESH (DDS)
Entity Type:Individual
Prefix:
First Name:HITESH
Middle Name:
Last Name:RATHOD
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 1:500 COVENTRY DR
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1970
Mailing Address - Country:US
Mailing Address - Phone:908-454-5612
Mailing Address - Fax:908-454-5617
Practice Address - Street 1:500 COVENTRY DR
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1970
Practice Address - Country:US
Practice Address - Phone:908-454-5612
Practice Address - Fax:908-454-5617
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI21097122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist