Provider Demographics
NPI:1871638783
Name:INMAN DENTAL CARE PC
Entity type:Organization
Organization Name:INMAN DENTAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SERAJUS
Authorized Official - Middle Name:SALEKIN
Authorized Official - Last Name:QUADERI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:908-754-5252
Mailing Address - Street 1:3 PROGRESS STREET
Mailing Address - Street 2:SUITE NO 101
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820
Mailing Address - Country:US
Mailing Address - Phone:908-754-5252
Mailing Address - Fax:908-754-6663
Practice Address - Street 1:3 PROGRESS STREET
Practice Address - Street 2:SUITE NO 101
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820
Practice Address - Country:US
Practice Address - Phone:908-754-5252
Practice Address - Fax:908-754-6663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ17788122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6792006Medicaid