Provider Demographics
NPI:1194564831
Name:GADRIA, JASPREET
Entity type:Individual
Prefix:
First Name:JASPREET
Middle Name:
Last Name:GADRIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6451 OXFORD AVE APT A212
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-5433
Mailing Address - Country:US
Mailing Address - Phone:951-533-3299
Mailing Address - Fax:
Practice Address - Street 1:6451 OXFORD AVE APT A212
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-5433
Practice Address - Country:US
Practice Address - Phone:951-533-3299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS044627122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist