Provider Demographics
NPI:1477783041
Name:TENDULKAR, SHAHNAZ (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHAHNAZ
Middle Name:
Last Name:TENDULKAR
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 1:2055 CENTER AVE
Mailing Address - Street 2:APT 14C
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-4948
Mailing Address - Country:US
Mailing Address - Phone:201-647-1741
Mailing Address - Fax:
Practice Address - Street 1:2055 CENTER AVE
Practice Address - Street 2:APT 14C
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-4948
Practice Address - Country:US
Practice Address - Phone:201-647-1741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP697141223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry