Provider Demographics
NPI:1659437143
Name:AFFINITY DENTAL CARE LLC
Entity Type:Organization
Organization Name:AFFINITY DENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJENDRA
Authorized Official - Middle Name:HARIPRASAD
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-668-4500
Mailing Address - Street 1:974 INMAN AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1177
Mailing Address - Country:US
Mailing Address - Phone:908-668-4500
Mailing Address - Fax:908-668-4501
Practice Address - Street 1:974 INMAN AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1177
Practice Address - Country:US
Practice Address - Phone:908-668-4500
Practice Address - Fax:908-668-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ144031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty