Provider Demographics
NPI:1184150815
Name:PADHIAR, DHEEREN (DMD)
Entity type:Individual
Prefix:
First Name:DHEEREN
Middle Name:
Last Name:PADHIAR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 COUNTRY DR
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-7222
Mailing Address - Country:US
Mailing Address - Phone:610-804-1408
Mailing Address - Fax:
Practice Address - Street 1:4130 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-3803
Practice Address - Country:US
Practice Address - Phone:610-284-4770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-01
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS00415021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice