Healthcare Provider Details

I. General information

NPI: 1073448957
Provider Name (Legal Business Name): RIDDHI DARJI DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 EASTON AVE
BETHLEHEM PA
18018-2624
US

IV. Provider business mailing address

658 WOOD AVE
COLONIA NJ
07067-2427
US

V. Phone/Fax

Practice location:
  • Phone: 610-819-7305
  • Fax:
Mailing address:
  • Phone: 732-770-8163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS045701
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: