Provider Demographics
NPI:1861064891
Name:YADAV, PRIYANKA (DMD)
Entity type:Individual
Prefix:DR
First Name:PRIYANKA
Middle Name:
Last Name:YADAV
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 1:235 BRYDON RD
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3306
Mailing Address - Country:US
Mailing Address - Phone:872-202-7002
Mailing Address - Fax:
Practice Address - Street 1:301 E CITY AVE STE G5
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1707
Practice Address - Country:US
Practice Address - Phone:215-390-3101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS043201122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist