Provider Demographics
NPI:1396754917
Name:RAMAKRISHNAN, JAYASHREE (DDS)
Entity type:Individual
Prefix:
First Name:JAYASHREE
Middle Name:
Last Name:RAMAKRISHNAN
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 1:23 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-4224
Mailing Address - Country:US
Mailing Address - Phone:973-226-1735
Mailing Address - Fax:
Practice Address - Street 1:4914 KENNEDY BLVD W
Practice Address - Street 2:SUITE 201
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-5590
Practice Address - Country:US
Practice Address - Phone:201-863-0090
Practice Address - Fax:201-863-9008
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI020350001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice