Provider Demographics
NPI:1497906309
Name:DADHANIA, ANUP RAJENDRA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANUP
Middle Name:RAJENDRA
Last Name:DADHANIA
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 1:1270 UPPER VALLEY PIKE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-4020
Mailing Address - Country:US
Mailing Address - Phone:937-525-0500
Mailing Address - Fax:937-525-0502
Practice Address - Street 1:1270 UPPER VALLEY PIKE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-4020
Practice Address - Country:US
Practice Address - Phone:937-525-0500
Practice Address - Fax:937-525-0502
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2012-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0137801223G0001X
OH300235891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0062098Medicaid