Provider Demographics
NPI:1316259534
Name:ANWAR, TABINDA (DDS)
Entity type:Individual
Prefix:DR
First Name:TABINDA
Middle Name:
Last Name:ANWAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 ROUTE 304
Mailing Address - Street 2:
Mailing Address - City:BARDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:10954-5570
Mailing Address - Country:US
Mailing Address - Phone:845-624-3188
Mailing Address - Fax:845-215-5850
Practice Address - Street 1:446 ROUTE 304
Practice Address - Street 2:
Practice Address - City:BARDONIA
Practice Address - State:NY
Practice Address - Zip Code:10954-5570
Practice Address - Country:US
Practice Address - Phone:845-624-3188
Practice Address - Fax:845-215-5850
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY055926122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program