Healthcare Provider Details

I. General information

NPI: 1417087529
Provider Name (Legal Business Name): AESHA CHAUDHRY DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 FOULK RD STE CANDD
WILMINGTON DE
19810-3700
US

IV. Provider business mailing address

1805 FOULK RD STE CANDD
WILMINGTON DE
19810-3700
US

V. Phone/Fax

Practice location:
  • Phone: 302-412-9646
  • Fax: 302-412-9646
Mailing address:
  • Phone: 302-412-9646
  • Fax: 302-412-9646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDS036119
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberG1-0001334
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDS036119
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberG1-0001334
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: