Anaheata Esmailzada, D.D.S

Individual provider Active NPI General Practice Dentistry · Lodi, NJ

NPI 1154590552 · NPPES record last updated Feb 29, 2008

Key facts

NPI
1154590552
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
22085 (NJ)
Practice address
1 S Main St Ste 6
Lodi, NJ 07644-2235
Phone
(973) 365-8009
Fax
(973) 777-0038
NPI assigned
Feb 29, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
22085NJMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22085 NJ Yes

Addresses

Primary practice location

1 S Main St Ste 6
Lodi, NJ 07644-2235

Mailing address

1 S Main St Ste 6
Lodi, NJ 07644-2235
Phone (973) 365-8009

Other providers in Lodi, NJ

All providers in Lodi, NJ · General Practice Dentistry in New Jersey

Sources for this page

Verify at the official NPI Registry.