Provider Demographics
NPI:1265600530
Name:PRIYA BAROT PC
Entity type:Organization
Organization Name:PRIYA BAROT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAROT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-335-2220
Mailing Address - Street 1:320 N OXFORD VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-2610
Mailing Address - Country:US
Mailing Address - Phone:215-335-2220
Mailing Address - Fax:
Practice Address - Street 1:320 N OXFORD VALLEY RD
Practice Address - Street 2:
Practice Address - City:FAIRLESS HILLS
Practice Address - State:PA
Practice Address - Zip Code:19030-2610
Practice Address - Country:US
Practice Address - Phone:215-335-2220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASHOK BAROT DDSPC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020825L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005292490001Medicaid