Provider Demographics
NPI:1558741629
Name:SENJALIA, ABHISHEK (DMD)
Entity Type:Individual
Prefix:
First Name:ABHISHEK
Middle Name:
Last Name:SENJALIA
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 1:22 HIGHVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-2814
Mailing Address - Country:US
Mailing Address - Phone:973-975-5715
Mailing Address - Fax:
Practice Address - Street 1:43 S LANSDOWNE AVE
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050-2804
Practice Address - Country:US
Practice Address - Phone:973-975-5715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040351122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist