Provider Demographics
NPI:1528232311
Name:VASANI, AMI AMIT (DMD)
Entity Type:Individual
Prefix:DR
First Name:AMI
Middle Name:AMIT
Last Name:VASANI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MS
Other - First Name:AMI
Other - Middle Name:R
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BDS
Mailing Address - Street 1:560 SPRINGFIELD AVE STE L
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-1024
Mailing Address - Country:US
Mailing Address - Phone:908-264-8335
Mailing Address - Fax:908-264-8316
Practice Address - Street 1:560 SPRINGFIELD AVE STE L
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-1024
Practice Address - Country:US
Practice Address - Phone:908-264-8335
Practice Address - Fax:908-264-8316
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI023720001223G0001X
NJDI02373000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice