Provider Demographics
NPI:1497866933
Name:AMANDEEP ARORA DDS PC
Entity Type:Organization
Organization Name:AMANDEEP ARORA DDS PC
Other - Org Name:WESTSIDE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:ARORA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:315-442-7779
Mailing Address - Street 1:4700 ONONDAGA BLVD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13219-3316
Mailing Address - Country:US
Mailing Address - Phone:315-442-7779
Mailing Address - Fax:315-442-1082
Practice Address - Street 1:4700 ONONDAGA BLVD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13219-3316
Practice Address - Country:US
Practice Address - Phone:315-442-7779
Practice Address - Fax:315-442-1082
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMANDEEP ARORA DDS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-31
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02332281Medicaid