Apeksha Hemangini Pole, DMD

Individual provider Active NPI General Practice Dentistry · Bogota, NJ

NPI 1699077115 · NPPES record last updated Jun 25, 2012

Key facts

NPI
1699077115
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
22DI02496600 (NJ)
Practice address
85 E Main St
Bogota, NJ 07603-1307
Phone
(617) 699-2786
NPI assigned
Dec 4, 2010
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
22DI02496600NJMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI02496600 NJ Yes

Addresses

Primary practice location

85 E Main St
Bogota, NJ 07603-1307

Mailing address

505 W 37TH St
Apt 21G
New York, NY 10018-1257
Phone (617) 699-2786

Other providers in Bogota, NJ

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

Sources for this page

Verify at the official NPI Registry.