Healthcare Provider Details

I. General information

NPI: 1023822053
Provider Name (Legal Business Name): AHUJA DENTAL NYC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 BROADWAY RM 612
NEW YORK NY
10007-2924
US

IV. Provider business mailing address

130 COPA DE ORO DR
BREA CA
92823-7013
US

V. Phone/Fax

Practice location:
  • Phone: 646-604-5700
  • Fax:
Mailing address:
  • Phone: 202-251-0408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. TARAN KAUR REYNOLDS
Title or Position: DENTIST OWNER
Credential:
Phone: 202-251-0408