Provider Demographics
NPI:1396838678
Name:DHALIWAL, TRIPINDER (DMD)
Entity Type:Individual
Prefix:DR
First Name:TRIPINDER
Middle Name:
Last Name:DHALIWAL
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:PO BOX 974
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-0974
Mailing Address - Country:US
Mailing Address - Phone:201-858-2218
Mailing Address - Fax:
Practice Address - Street 1:919 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3051
Practice Address - Country:US
Practice Address - Phone:201-858-2218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ14451N1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice