Healthcare Provider Details

I. General information

NPI: 1992645006
Provider Name (Legal Business Name): AJK DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 MAYHILL ST
SADDLE BROOK NJ
07663-5307
US

IV. Provider business mailing address

180 CHAMBERLAIN PL
MIDLAND PARK NJ
07432-1656
US

V. Phone/Fax

Practice location:
  • Phone: 845-522-2609
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: JIGISHA TAMAKUWALA
Title or Position: OWNER
Credential: DDS
Phone: 845-522-2609