Provider Demographics
NPI:1427279066
Name:WADHWA, SUNIL (DDS)
Entity type:Individual
Prefix:DR
First Name:SUNIL
Middle Name:
Last Name:WADHWA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 W 168TH STREET
Mailing Address - Street 2:P & S BOX 20, VC9-219
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032
Mailing Address - Country:US
Mailing Address - Phone:212-305-2425
Mailing Address - Fax:212-305-4609
Practice Address - Street 1:630 W 168TH STREET
Practice Address - Street 2:P & S BOX 20, VC9-219
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-305-2425
Practice Address - Fax:212-305-4609
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0554241223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics