Provider Demographics
NPI:1740779412
Name:AJAY SETYA, DDS, INC
Entity Type:Organization
Organization Name:AJAY SETYA, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOLTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-364-2850
Mailing Address - Street 1:27871 MEDICAL CENTER RD STE 260
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6406
Mailing Address - Country:US
Mailing Address - Phone:949-364-2850
Mailing Address - Fax:949-364-9218
Practice Address - Street 1:27871 MEDICAL CENTER RD STE 260
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6406
Practice Address - Country:US
Practice Address - Phone:949-364-2850
Practice Address - Fax:949-364-9218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44081122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty