Provider Demographics
NPI:1740479393
Name:TRIVEDI, SANDHYA MEHUL (DDS)
Entity type:Individual
Prefix:DR
First Name:SANDHYA
Middle Name:MEHUL
Last Name:TRIVEDI
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 1:1 GREENTREE CTR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3105
Mailing Address - Country:US
Mailing Address - Phone:856-983-2983
Mailing Address - Fax:856-983-8331
Practice Address - Street 1:1 GREENTREE CTR
Practice Address - Street 2:SUITE 106
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3105
Practice Address - Country:US
Practice Address - Phone:856-983-2983
Practice Address - Fax:856-983-8331
Is Sole Proprietor?:No
Enumeration Date:2007-10-19
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0190911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice