Provider Demographics
NPI:1952734303
Name:PADMAWAR, ANAGHA A (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANAGHA
Middle Name:A
Last Name:PADMAWAR
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 1:25 RIVER DR S
Mailing Address - Street 2:APT 207
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07310-5700
Mailing Address - Country:US
Mailing Address - Phone:914-413-4566
Mailing Address - Fax:
Practice Address - Street 1:551 ANDERSON AVE
Practice Address - Street 2:
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010-1722
Practice Address - Country:US
Practice Address - Phone:914-413-4566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-20
Last Update Date:2013-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS039727122300000X
NJ22DI02547300122300000X
CT11058122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist