Provider Demographics
NPI:1902955289
Name:PATHAK, VINKY S (DDS)
Entity Type:Individual
Prefix:DR
First Name:VINKY
Middle Name:S
Last Name:PATHAK
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 1:1251 S. CEDAR CREST BLVD
Mailing Address - Street 2:SUITE 207C
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103
Mailing Address - Country:US
Mailing Address - Phone:610-437-9000
Mailing Address - Fax:610-437-6298
Practice Address - Street 1:1251 S. CEDAR CREST BLVD
Practice Address - Street 2:SUITE 207C
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103
Practice Address - Country:US
Practice Address - Phone:610-437-9000
Practice Address - Fax:610-437-6298
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0359571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice