Provider Demographics
NPI:1952319048
Name:GOWDA, UMA (DMD)
Entity type:Individual
Prefix:DR
First Name:UMA
Middle Name:
Last Name:GOWDA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 E MIDLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4116
Mailing Address - Country:US
Mailing Address - Phone:201-634-1465
Mailing Address - Fax:201-634-1476
Practice Address - Street 1:144 E MIDLAND AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-4116
Practice Address - Country:US
Practice Address - Phone:201-634-1465
Practice Address - Fax:201-634-1476
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI20812122300000X
NY048484122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist