Herawati T Kandou Dds Pa in Elizabeth - Dentist
Herawati T Kandou Dds Pa - NPI 1871666586
Herawati T Kandou Dds Pa is a Dentist in Elizabeth, New Jersey. Herawati T Kandou Dds Pa practices all healthcare services and medical treatments related to Dentist. The NPI Number for Herawati T Kandou Dds Pa is 1871666586. The last update date is 2008-05-30.
Herawati T Kandou Dds Pa's current location address is 35 Jefferson Avenue, Elizabeth, New Jersey. You can contact this provider via phone number 9083541188 and fax number 9083527390. The mailing address for Herawati T Kandou Dds Pa is 35 Jefferson Avenue, Elizabeth, New Jersey. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Herawati T Kandou Dds Pa |
|---|---|
| Address | 35 Jefferson Avenue, Elizabeth, New Jersey |
| Phone Number | 9083541188 |
| Fax Number | 9083527390 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Kandou T Herawati |
| Credentials | DDS |
| Telephone Number | 9083541188 |
NPI Number Detail
| NPI Number | 1871666586 |
|---|---|
| Provider Enumeration Date | 2006-11-17 |
| Last Updated Date | 2008-05-30 |
Provider Mailing Address Detail
| Address | 35 Jefferson Avenue |
|---|---|
| City | Elizabeth |
| State | New Jersey (NJ) |
| Post Code | 72012425 |
| Phone Number | 9083541188 |
| Fax Number | 9083527390 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 9708 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 314120901 | NJ | -- |
Post Comment/ Review Below
Could you please share the complete physical address where Herawati T Kandou Dds Pa is geographically located?
The Herawati T Kandou Dds Pa is physically situated at the following location: 35 Jefferson Avenue, Elizabeth, NJ, 72012425.
What is Herawati T Kandou Dds Pa's area of expertise and its corresponding taxonomy classification?
The Herawati T Kandou Dds Pa's field of specialization is Dentist, and it falls under the taxonomy code 122300000X, which categorizes healthcare providers based on their areas of practice.
What is Herawati T Kandou Dds Pa's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Herawati T Kandou Dds Pa is Dentist, and the taxonomy code that classifies this field of practice is 122300000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1871666586 to Herawati T Kandou Dds Pa?
The Centers for Medicare & Medicaid Services originally issued the 1871666586 to Herawati T Kandou Dds Pa on 2006-11-17.
As of what date were the details pertaining to Herawati T Kandou Dds Pa last refreshed?
The information related to the Herawati T Kandou Dds Pa, including its address, specialty, and other relevant details, was last updated on 2008-05-30.