Provider Demographics
NPI:1023134053
Name:ELY, ANJOO CHAUDHRY (DDS)
Entity type:Individual
Prefix:DR
First Name:ANJOO
Middle Name:CHAUDHRY
Last Name:ELY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24275 NOVI ROAD
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375
Mailing Address - Country:US
Mailing Address - Phone:248-735-1882
Mailing Address - Fax:248-347-1198
Practice Address - Street 1:24275 NOVI RD
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-2403
Practice Address - Country:US
Practice Address - Phone:248-347-3030
Practice Address - Fax:248-347-1198
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010172771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice