Provider Demographics
NPI:1568554830
Name:BOGGAVARAPU, NAVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:NAVIN
Middle Name:
Last Name:BOGGAVARAPU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:NAVIN
Other - Middle Name:
Other - Last Name:BOGG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:221 CHESTNUT ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203-1297
Mailing Address - Country:US
Mailing Address - Phone:908-245-1615
Mailing Address - Fax:
Practice Address - Street 1:221 CHESTNUT ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:ROSELLE
Practice Address - State:NJ
Practice Address - Zip Code:07203-1297
Practice Address - Country:US
Practice Address - Phone:908-245-1615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI196781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice