Provider Demographics
NPI:1215146782
Name:SAHASRABUDHE, ASHISH (DMD)
Entity type:Individual
Prefix:DR
First Name:ASHISH
Middle Name:
Last Name:SAHASRABUDHE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-3991
Mailing Address - Country:US
Mailing Address - Phone:347-886-3724
Mailing Address - Fax:
Practice Address - Street 1:1103 STEWART AVE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4886
Practice Address - Country:US
Practice Address - Phone:516-222-1822
Practice Address - Fax:516-227-5361
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0524381223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics