Provider Demographics
NPI:1962799783
Name:JHAVERI, ANKUR P (DMD)
Entity type:Individual
Prefix:DR
First Name:ANKUR
Middle Name:P
Last Name:JHAVERI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ASYLUM AVE
Mailing Address - Street 2:SUITE 3200
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-1770
Mailing Address - Country:US
Mailing Address - Phone:860-714-4529
Mailing Address - Fax:860-714-8003
Practice Address - Street 1:1177 SILAS DEANE HWY
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-4348
Practice Address - Country:US
Practice Address - Phone:860-563-6080
Practice Address - Fax:860-529-4420
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT01811122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004011136Medicaid