Provider Demographics
NPI:1679808463
Name:AHUJA, SWATI (BDS, MDS)
Entity Type:Individual
Prefix:
First Name:SWATI
Middle Name:
Last Name:AHUJA
Suffix:
Gender:F
Credentials:BDS, MDS
Other - Prefix:
Other - First Name:SWATI
Other - Middle Name:
Other - Last Name:JOTWANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BDS, MDS
Mailing Address - Street 1:875 UNION AVE
Mailing Address - Street 2:DUNN DENTAL BUILDING, ROOM C 302
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-3513
Mailing Address - Country:US
Mailing Address - Phone:901-448-6476
Mailing Address - Fax:901-448-1390
Practice Address - Street 1:875 UNION AVE
Practice Address - Street 2:DUNN DENTAL BUILDING, ROOM C 302
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-3513
Practice Address - Country:US
Practice Address - Phone:901-448-6476
Practice Address - Fax:901-448-1390
Is Sole Proprietor?:No
Enumeration Date:2009-10-12
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000090321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice