=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487468427
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AHUJA DENTAL NYC PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/01/2025
-----------------------------------------------------
Last Update Date | 02/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 333 E 14TH ST
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10003-4208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-473-9002
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 130 COPA DE ORO DR
-----------------------------------------------------
City | BREA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92823-7013
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-251-0408
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DENTIST OWNER
-----------------------------------------------------
Name | DR. TARAN KAUR REYNOLDS
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 202-251-0408
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------