Healthcare Provider Details

I. General information

NPI: 1376462036
Provider Name (Legal Business Name): AJAY MATHUR DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 S EL CAMINO REAL
SAN MATEO CA
94402-2311
US

IV. Provider business mailing address

973 MARQUETTE LN
FOSTER CITY CA
94404-2916
US

V. Phone/Fax

Practice location:
  • Phone: 510-838-5268
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. AJAY MATHUR
Title or Position: CEO
Credential: DDS
Phone: 860-578-8394