Provider Demographics
NPI:1881962108
Name:MISTRY, ARNAV R (DMD)
Entity type:Individual
Prefix:DR
First Name:ARNAV
Middle Name:R
Last Name:MISTRY
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 1:218 SADDLEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-7834
Mailing Address - Country:US
Mailing Address - Phone:215-698-9404
Mailing Address - Fax:
Practice Address - Street 1:810 BARNEGAT AVE STE A
Practice Address - Street 2:
Practice Address - City:SHIP BOTTOM
Practice Address - State:NJ
Practice Address - Zip Code:08008
Practice Address - Country:US
Practice Address - Phone:609-361-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-01
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI025909001223E0200X
PADS0389011223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics