Provider Demographics
NPI:1548300312
Name:JOSHI, PADMA (DDS)
Entity type:Individual
Prefix:DR
First Name:PADMA
Middle Name:
Last Name:JOSHI
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 1:124 GREGORY AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-4856
Mailing Address - Country:US
Mailing Address - Phone:973-859-0538
Mailing Address - Fax:
Practice Address - Street 1:124 GREGORY AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-4856
Practice Address - Country:US
Practice Address - Phone:973-859-0538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2008-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0474111223P0221X
NJ22DI0201951223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01421705Medicaid