Provider Demographics
NPI:1184018061
Name:BANGALORE MARAPPA, YASHASHWINI (DDS)
Entity type:Individual
Prefix:
First Name:YASHASHWINI
Middle Name:
Last Name:BANGALORE MARAPPA
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 RAMAPO VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-1199
Mailing Address - Country:US
Mailing Address - Phone:201-529-9000
Mailing Address - Fax:201-529-2633
Practice Address - Street 1:156 RAMAPO VALLEY RD
Practice Address - Street 2:
Practice Address - City:MAHWAH
Practice Address - State:NJ
Practice Address - Zip Code:07430-1199
Practice Address - Country:US
Practice Address - Phone:201-529-9000
Practice Address - Fax:201-529-2633
Is Sole Proprietor?:No
Enumeration Date:2015-03-27
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02635100122300000X
NY059705122300000X
NJ066951223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1184018061Medicaid