Provider Demographics
NPI:1629173877
Name:AHUJA, CHANDAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHANDAN
Middle Name:
Last Name:AHUJA
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 1:300 STATE ROUTE 18
Mailing Address - Street 2:UNIT 28 MIDSTATE MALL
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-1912
Mailing Address - Country:US
Mailing Address - Phone:732-254-9000
Mailing Address - Fax:732-254-1999
Practice Address - Street 1:300 STATE ROUTE 18
Practice Address - Street 2:UNIT 28 MIDSTATE MALL
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-1912
Practice Address - Country:US
Practice Address - Phone:732-254-9000
Practice Address - Fax:732-254-1999
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ221431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice