Provider Demographics
NPI:1619163920
Name:DHARIA, ASMITA A (DDS)
Entity Type:Individual
Prefix:DR
First Name:ASMITA
Middle Name:A
Last Name:DHARIA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 RED HAWK CIR
Mailing Address - Street 2:N-304
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-4747
Mailing Address - Country:US
Mailing Address - Phone:510-505-9522
Mailing Address - Fax:
Practice Address - Street 1:423 N L ST
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94551-8005
Practice Address - Country:US
Practice Address - Phone:925-449-7167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54247122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist