Dr. Herawati Tirtadjaja Kandou
Dentist Orthodontists
35 Jefferson Avenue
Elizabeth
, New Jersey 07201-2425
Dr. Herawati Tirtadjaja Kandou
Dentist Orthodontists
35 Jefferson Avenue
Elizabeth
, New Jersey 07201-2425
(908) 352-7390
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About
Features
Specialties
- Dentist
- Orthodontists
Languages spoken
- English
Location
First Address
- Dr. Herawati Tirtadjaja Kandou
- 35 Jefferson Avenue
- Elizabeth, NJ
- Zip : 07201-2425
- Fax : (908) 352-7390
- Phone : (908) 354-1188
Second Address
- Dr. Herawati Tirtadjaja Kandou
- 35 Jefferson Avenue
- Elizabeth, NJ
- Zip : 07201-2425
- Fax : (908) 352-7390
- Phone : (908) 354-1188
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FAQs
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Is Dr. Herawati Tirtadjaja Kandou a sole practitioner?
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Does Dr. Herawati Tirtadjaja Kandou offers telemedicine?
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Does Dr. Herawati Tirtadjaja Kandou have any license restrictions?
Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 122300000X | Dentist | 9708 | NJ |
| N | 1223X0400X | Orthodontists | 3026 | NJ |
National Provider Identifier
| NPI | 1023246105 |
|---|---|
| Provider Name | Dr. Herawati Tirtadjaja Kandou |
| First Address | Elizabeth, NJ 07201-2425 |
| Second Address | Elizabeth, NJ 07201-2425 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/06/2009 |
| Last Update Date | 26/06/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 3141209-01 | (05) | NJ |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.