Provider Demographics
NPI:1194324897
Name:JIGNESH RUDANI DMD PC
Entity type:Organization
Organization Name:JIGNESH RUDANI DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JIGNESH
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDANI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MSPH
Authorized Official - Phone:610-866-8501
Mailing Address - Street 1:3400 BATH PIKE STE 200
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-2484
Mailing Address - Country:US
Mailing Address - Phone:610-866-8501
Mailing Address - Fax:
Practice Address - Street 1:3400 BATH PIKE STE 200
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-2484
Practice Address - Country:US
Practice Address - Phone:610-866-8501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental