Provider Demographics
NPI:1801218789
Name:CHOUDHARY GEETA DDS PC
Entity Type:Organization
Organization Name:CHOUDHARY GEETA DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOUDHARY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:845-216-7737
Mailing Address - Street 1:422 PASCACK RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:TOWNSHIP OF WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07676-4837
Mailing Address - Country:US
Mailing Address - Phone:201-497-3990
Mailing Address - Fax:201-497-3992
Practice Address - Street 1:422 PASCACK RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:TOWNSHIP OF WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07676-4837
Practice Address - Country:US
Practice Address - Phone:201-497-3990
Practice Address - Fax:201-497-3992
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GEETA CHOUDHARY DDS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02159800122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty