Dr. Herawati T Kandou, DDS
Dentist in Elizabeth, New Jersey
1023246105- Practice location
- 35 Jefferson Avenue, Elizabeth, NJ 07201-2425
- Phone
- 908-354-1188
- Fax
- 908-352-7390
- Last updated
- June 26, 2009
Herawati Tirtadjaja Kandou is a Dentist based in Elizabeth, NJ. Herawati Tirtadjaja Kandou practices in Elizabeth, NJ and has the professional credentials of DDS. The NPI Number for Herawati Tirtadjaja Kandou is 1023246105 and holds a License No. 9708 (NJ). The current practice location address for Herawati Tirtadjaja Kandou is 35 Jefferson Avenue, Elizabeth, NJ 07201-2425 and can be reached out via phone at 908-354-1188 and via fax at 908-352-7390.
Provider Profile Details
- NPI Number
- 1023246105
- Provider Name
- Herawati Tirtadjaja Kandou
- Credential
- DDS
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 35 Jefferson Avenue, Elizabeth, NJ 07201-2425
- Phone Number
- 908-354-1188
- Fax Number
- 908-352-7390
- Primary Taxonomy
- Dentist · 122300000X
- Sole Proprietor
- No
- Provider Enumeration Date
- June 26, 2009
- Last Update Date
- June 26, 2009
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 35 Jefferson Avenue
Elizabeth, NJ 07201-2425 - City
- Elizabeth
- State
- New Jersey
- Zip
- 07201-2425
- Phone Number
- 908-354-1188
- Fax Number
- 908-352-7390
Provider Business Mailing Address Details
- Address
- 35 Jefferson Avenue
Elizabeth, NJ 07201-2425 - City
- Elizabeth
- State
- NJ
- Zip
- 07201-2425
- Phone Number
- 908-354-1188
- Fax Number
- 908-352-7390
License Information
- License Number (1)
- 9708
- License State (1)
- NJ
- Taxonomy (1)
- Dentist · 122300000X · Primary
- License Number (2)
- 3026
- License State (2)
- NJ
- Taxonomy (2)
- Dentist, Orthodontics and Dentofacial Orthopedics · 1223X0400X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Dentists near Elizabeth, NJ
View all Dentists in Elizabeth →Frequently Asked Questions
What is the NPI number of Dr. Herawati T Kandou, DDS?
The NPI number of Dr. Herawati T Kandou, DDS is 1023246105. It was assigned on June 26, 2009 and is currently active in the NPPES registry.
What is the specialty of Dr. Herawati T Kandou, DDS?
Dr. Herawati T Kandou, DDS is registered under the primary taxonomy Dentist (code 122300000X), licensed in NJ under license number 9708.
Where does Dr. Herawati T Kandou, DDS practice?
The practice location is 35 Jefferson Avenue, Elizabeth, NJ 07201-2425. The office can be reached at 908-354-1188 (phone) or 908-352-7390 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1023246105 directly on the NPPES registry website.