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General NPI Number Information
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NPI Number | 1174218044
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Entity Type | Individual
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Provider Name | IVAN ALKHWEKHI DMD
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Gender | Male
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Dates
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Enumeration Date | 04/06/2023
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 475 N BRIDGE ST
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-2153
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Country | US
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Telephone | 201-637-2054
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Fax |
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Provider Business Mailing Address
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Address Line | 17 SQUIRE TER
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City | COLTS NECK
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State | NJ
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Zip | 07722-1021
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Country | US
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Telephone |
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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 | 22DI02971000
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License Number State | NJ
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