Provider Demographics
NPI:1528420965
Name:ANGRA, SALONI (DMD)
Entity type:Individual
Prefix:DR
First Name:SALONI
Middle Name:
Last Name:ANGRA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 S MAIN ST STE D
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-2837
Mailing Address - Country:US
Mailing Address - Phone:609-737-7662
Mailing Address - Fax:
Practice Address - Street 1:245 S MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-2837
Practice Address - Country:US
Practice Address - Phone:609-737-7662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18572531223G0001X
390200000X
NJ22DI027565001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program