Provider Demographics
NPI:1922515964
Name:PEIRIS, DILINI KANCHANA (DDS)
Entity Type:Individual
Prefix:
First Name:DILINI
Middle Name:KANCHANA
Last Name:PEIRIS
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 1:265 STATE ROUTE 34 STE D
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-2436
Mailing Address - Country:US
Mailing Address - Phone:732-431-0800
Mailing Address - Fax:732-431-1694
Practice Address - Street 1:265 STATE ROUTE 34 STE D
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-2436
Practice Address - Country:US
Practice Address - Phone:732-431-0800
Practice Address - Fax:732-431-1694
Is Sole Proprietor?:No
Enumeration Date:2017-12-29
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ390200000X
NJD102709900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program