Provider Demographics
NPI:1821061763
Name:DHAR, AMIT KIRAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMIT
Middle Name:KIRAN
Last Name:DHAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1613 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2603
Mailing Address - Country:US
Mailing Address - Phone:516-616-4800
Mailing Address - Fax:516-616-0364
Practice Address - Street 1:1613 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2603
Practice Address - Country:US
Practice Address - Phone:516-616-4800
Practice Address - Fax:516-616-0364
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYA0453571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY30798OtherAETNA HMO/DMO
NY0002490OtherGUARDIAN MDG
NY158091OtherCIGNA HMO
NY02249374Medicaid