Provider Demographics
NPI:1760615603
Name:AJMERA, HEMALI M (DDS)
Entity Type:Individual
Prefix:DR
First Name:HEMALI
Middle Name:M
Last Name:AJMERA
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 1:20934 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-2419
Mailing Address - Country:US
Mailing Address - Phone:718-423-6148
Mailing Address - Fax:
Practice Address - Street 1:5718 WOODSIDE AVE
Practice Address - Street 2:STE 203
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-3444
Practice Address - Country:US
Practice Address - Phone:718-424-6201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY54512122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist