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General NPI Number Information
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NPI Number | 1104460260
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Entity Type | Individual
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Provider Name | NEERAJ TREHAN DMD
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Gender | Male
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Dates
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Enumeration Date | 11/01/2019
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 206 W IRELAND RD
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City | SOUTH BEND
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State | IN
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Zip | 46614-2506
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Country | US
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Telephone | 913-905-2711
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Fax |
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Provider Business Mailing Address
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Address Line | 206 W IRELAND RD
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City | SOUTH BEND
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State | IN
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Zip | 46614-2506
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Country | US
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Telephone | 913-905-2711
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2021021829
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 62031
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12014317A
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License Number State | IN
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