Provider Demographics
NPI:1356330658
Name:KADIA, RATILAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:RATILAL
Middle Name:
Last Name:KADIA
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 1:779 WENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-4942
Mailing Address - Country:US
Mailing Address - Phone:718-706-7770
Mailing Address - Fax:718-562-2035
Practice Address - Street 1:4705 44TH ST
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-6348
Practice Address - Country:US
Practice Address - Phone:718-706-7770
Practice Address - Fax:718-562-2035
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0356611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00641103Medicaid