Provider Demographics
NPI:1215343223
Name:MATHUR, DIPTI CHANDRA (DDS)
Entity type:Individual
Prefix:DR
First Name:DIPTI
Middle Name:CHANDRA
Last Name:MATHUR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:DIPTI
Other - Middle Name:
Other - Last Name:CHANDRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2794 MERIDIAN DR UNIT 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-6255
Mailing Address - Country:US
Mailing Address - Phone:412-605-4841
Mailing Address - Fax:
Practice Address - Street 1:1851 MACGREGOR DOWNS RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5925
Practice Address - Country:US
Practice Address - Phone:252-737-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9827122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist