Basic Information
| Provider Information | |||||||||
| NPI: | 1306299086 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHOWDHARY | ||||||||
| FirstName: | ANSHUJA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 34 UNION SQ | ||||||||
| Address2: | APT 368 | ||||||||
| City: | UNION CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945878503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4158660455 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 22421 HESPERIAN BLVD | ||||||||
| Address2: | |||||||||
| City: | HAYWARD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5107824161 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2016 | ||||||||
| LastUpdateDate: | 08/28/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 100396 | CA | Y | Dental Providers | Dentist | General Practice |
No ID Information.