Provider Demographics
NPI:1992275358
Name:AHUJA, VINTI (DMD)
Entity type:Individual
Prefix:DR
First Name:VINTI
Middle Name:
Last Name:AHUJA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:VINTI
Other - Middle Name:
Other - Last Name:SAINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BDS
Mailing Address - Street 1:5316 JUDGE RD
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-1178
Mailing Address - Country:US
Mailing Address - Phone:412-620-3376
Mailing Address - Fax:
Practice Address - Street 1:3024 VICTORIA ST
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-2793
Practice Address - Country:US
Practice Address - Phone:563-242-4917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-096121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice