Dr. Herawati Tirtadjaja Kandou is a Elizabeth, New Jersey based Dentist who is specialized in Dentistry. She does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Dr. Herawati Tirtadjaja Kandou is 9708 for Dentistry in New Jersey. Her current practice location is 35 Jefferson Avenue, Elizabeth. Patients can reach her at 908-354-1188.
Dr. Herawati Tirtadjaja Kandou is the primary dental care provider for patients of all ages. She is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Dr. Herawati Tirtadjaja Kandou speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Name:
Dr. Herawati Tirtadjaja Kandou
Specialization:
Dentist
Gender:
Female
Credentials:
DDS
Accepts Medicare Assignment:
No
Practice Address:
35 Jefferson Avenue, Elizabeth, New Jersey, 07201-2425
Phone:
908-354-1188
Fax:
908-352-7390
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1023246105
NPI Enumeration Date:
26 Jun, 2009
NPI Last Update On:
26 Jun, 2009
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Herawati Tirtadjaja Kandou are as mentioned below.
License Number
Specialization
State
Status
9708
Dentistry
New Jersey
Primary
3026
Orthodontics and Dentofacial Orthopedics
New Jersey
Secondary
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Herawati Tirtadjaja Kandou such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
3141209-01
Medicaid
New Jersey
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
35 Jefferson Avenue, Elizabeth, New Jersey
Zip:
07201-2425
Phone Number:
908-354-1188
Fax Number:
908-352-7390
Patients can reach Dr. Herawati Tirtadjaja Kandou at 35 Jefferson Avenue, Elizabeth, New Jersey or can call to book an appointment on 908-354-1188. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.