Provider Demographics
NPI:1710051701
Name:TANEJA, PUJA (DDS)
Entity Type:Individual
Prefix:
First Name:PUJA
Middle Name:
Last Name:TANEJA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 WESTCHESTER AVE
Mailing Address - Street 2:SUITE 1M
Mailing Address - City:PORT CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10573-3650
Mailing Address - Country:US
Mailing Address - Phone:914-939-3413
Mailing Address - Fax:
Practice Address - Street 1:388 WESTCHESTER AVE
Practice Address - Street 2:SUITE 1M
Practice Address - City:PORT CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10573-3650
Practice Address - Country:US
Practice Address - Phone:914-939-3413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054333122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist