Provider Demographics
NPI:1689713075
Name:SETYA, AJAY BATRA (DDS MSD)
Entity Type:Individual
Prefix:DR
First Name:AJAY
Middle Name:BATRA
Last Name:SETYA
Suffix:
Gender:M
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23261 CASTLE ROCK
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-1690
Mailing Address - Country:US
Mailing Address - Phone:949-951-8122
Mailing Address - Fax:
Practice Address - Street 1:27871 MEDICAL CENTER RD
Practice Address - Street 2:SUITE 260
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6404
Practice Address - Country:US
Practice Address - Phone:949-363-2850
Practice Address - Fax:949-364-9218
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA440811223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics