NPI 1023246105

Herawati Tirtadjaja Kandou, DDS

Practitioner Dentist Elizabeth, NJ

Practice location

Address: 35 Jefferson Avenue, Elizabeth, NJ 07201-2425
Phone: (908) 354-1188
Fax: (908) 352-7390

Registered specialties (2)

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 9708 (NJ)

Other Dentist providers in New Jersey →

Orthodontics and Dentofacial Orthopedics Dentistry

Dental Providers Taxonomy 1223X0400X Licence 3026 (NJ)

Registry record

NPI: 1023246105
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Jun 2009
Record last updated: 26 Jun 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.