Provider Demographics
NPI:1750301131
Name:TRAKTHMAN, IRENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:
Last Name:TRAKTHMAN
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 1:2229 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-4402
Mailing Address - Country:US
Mailing Address - Phone:732-940-0222
Mailing Address - Fax:732-940-5532
Practice Address - Street 1:2229 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-4402
Practice Address - Country:US
Practice Address - Phone:732-940-0222
Practice Address - Fax:732-940-5532
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ200921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice