Provider Demographics
NPI:1285828228
Name:BANGA, POOJA (DMD)
Entity type:Individual
Prefix:DR
First Name:POOJA
Middle Name:
Last Name:BANGA
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:POOJA
Other - Middle Name:
Other - Last Name:TRIPATHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:660 COOPER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-9394
Mailing Address - Country:US
Mailing Address - Phone:614-888-6811
Mailing Address - Fax:
Practice Address - Street 1:660 COOPER RD STE 200
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-9394
Practice Address - Country:US
Practice Address - Phone:614-888-6811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30022519122300000X
OH30-0225191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice