Provider Demographics
NPI:1851015960
Name:NEERU CHOUDHARY DDS
Entity Type:Organization
Organization Name:NEERU CHOUDHARY DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NEERU
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOUDHARY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-364-9276
Mailing Address - Street 1:5150 GRAVES AVE STE 12D
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-5015
Mailing Address - Country:US
Mailing Address - Phone:408-252-1222
Mailing Address - Fax:
Practice Address - Street 1:5150 GRAVES AVE STE 12D
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-5015
Practice Address - Country:US
Practice Address - Phone:408-252-1222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental