Provider Demographics
NPI:1982781589
Name:ANAND, SUBINA (DMD)
Entity Type:Individual
Prefix:
First Name:SUBINA
Middle Name:
Last Name:ANAND
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 1:17 GROVERS MILL RD
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-3144
Mailing Address - Country:US
Mailing Address - Phone:609-275-9111
Mailing Address - Fax:
Practice Address - Street 1:24 MERCHANTS WAY
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-1570
Practice Address - Country:US
Practice Address - Phone:173-243-1757
Practice Address - Fax:173-243-1807
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1019791011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7196601Medicaid