Healthcare Provider Details

I. General information

NPI: 1568259042
Provider Name (Legal Business Name): ANKITA SIBAL
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 COUNTY RD 516
OLD BRIDGE NJ
08857-4605
US

IV. Provider business mailing address

13 TORBET RD
HILLSBOROUGH NJ
08844-7113
US

V. Phone/Fax

Practice location:
  • Phone: 732-679-3600
  • Fax:
Mailing address:
  • Phone: 732-289-4485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI03146000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: