Provider Demographics
NPI:1861232118
Name:GUNDARANIA, NIDHI
Entity type:Individual
Prefix:DR
First Name:NIDHI
Middle Name:
Last Name:GUNDARANIA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 SHARON GARDEN CT
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-4325
Mailing Address - Country:US
Mailing Address - Phone:201-519-5904
Mailing Address - Fax:
Practice Address - Street 1:3655 MUNICIPAL DR
Practice Address - Street 2:
Practice Address - City:HOKENDAUQUA
Practice Address - State:PA
Practice Address - Zip Code:18052
Practice Address - Country:US
Practice Address - Phone:610-432-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-24
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0447311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice