Provider Demographics
NPI:1801133293
Name:DHINGRA, AJAY KUMAR
Entity type:Individual
Prefix:
First Name:AJAY
Middle Name:KUMAR
Last Name:DHINGRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 FARMINGTON AVE RM L6053
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-1615
Mailing Address - Country:US
Mailing Address - Phone:860-679-8388
Mailing Address - Fax:860-679-1370
Practice Address - Street 1:263 FARMINGTON AVE RM L6053
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-1615
Practice Address - Country:US
Practice Address - Phone:860-679-8388
Practice Address - Fax:860-679-1370
Is Sole Proprietor?:No
Enumeration Date:2013-01-06
Last Update Date:2013-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0106951223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics