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General NPI Number Information
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NPI Number | 1215892278
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Entity Type | Organization
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Legal Business Name | TOOTH-SI LLC
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Dates
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Enumeration Date | 12/22/2025
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 6907 BERGENLINE AVE
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City | GUTTENBERG
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State | NJ
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Zip | 07093-1809
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Country | US
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Telephone | 201-662-8686
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Fax |
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Provider Business Mailing Address
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Address Line | 22 E WASHINGTON AVE
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City | ELMWOOD PARK
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State | NJ
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Zip | 07407-2804
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Country | US
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Telephone | 609-815-9803
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | VEENA KOTHAWAR
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Credential | DDS
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Telephone | 609-815-9803
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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 |
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License Number State |
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