Provider Demographics
NPI:1790343655
Name:VAKHARIA, NEEL SURESH (DMD)
Entity Type:Individual
Prefix:DR
First Name:NEEL
Middle Name:SURESH
Last Name:VAKHARIA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 GLENDALE LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-1919
Mailing Address - Country:US
Mailing Address - Phone:973-882-9715
Mailing Address - Fax:
Practice Address - Street 1:1544 KUSER RD
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3830
Practice Address - Country:US
Practice Address - Phone:609-585-1616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY059388-1122300000X
NJ22DI02754600122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist