Provider Demographics
NPI:1376739045
Name:QADRI, DANISH (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANISH
Middle Name:
Last Name:QADRI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-1201
Mailing Address - Country:US
Mailing Address - Phone:732-388-2822
Mailing Address - Fax:732-388-3115
Practice Address - Street 1:296 LAKE AVE
Practice Address - Street 2:
Practice Address - City:COLONIA
Practice Address - State:NJ
Practice Address - Zip Code:07067-1201
Practice Address - Country:US
Practice Address - Phone:732-388-2822
Practice Address - Fax:732-388-3115
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02351300122300000X, 1223G0001X
NC89481223G0001X
NY0541681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist