Provider Demographics
NPI:1811136104
Name:SHROTRIYA, ADYA (DDS)
Entity type:Individual
Prefix:
First Name:ADYA
Middle Name:
Last Name:SHROTRIYA
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 1:100 ELM ST
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-3810
Mailing Address - Country:US
Mailing Address - Phone:203-933-0008
Mailing Address - Fax:
Practice Address - Street 1:123 CORNELIA ST
Practice Address - Street 2:
Practice Address - City:EAST RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07073-1502
Practice Address - Country:US
Practice Address - Phone:201-935-9308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0099841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice