Provider Demographics
NPI:1689160509
Name:AGNIHOTRI, VARSHA (DMD)
Entity Type:Individual
Prefix:DR
First Name:VARSHA
Middle Name:
Last Name:AGNIHOTRI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 JUNIPER CT
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-2609
Mailing Address - Country:US
Mailing Address - Phone:908-227-0999
Mailing Address - Fax:
Practice Address - Street 1:20 VANDERBURG RD
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1440
Practice Address - Country:US
Practice Address - Phone:732-294-0045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02721000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist