Provider Demographics
NPI:1487989992
Name:PADAYATTIL, GEENA DAVIS (DMD)
Entity type:Individual
Prefix:DR
First Name:GEENA
Middle Name:DAVIS
Last Name:PADAYATTIL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 STATE ROUTE 27
Mailing Address - Street 2:SUITE2700
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-3979
Mailing Address - Country:US
Mailing Address - Phone:732-846-7701
Mailing Address - Fax:
Practice Address - Street 1:1527 STATE ROUTE 27
Practice Address - Street 2:SUITE2700
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3979
Practice Address - Country:US
Practice Address - Phone:732-846-7701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1024243001223G0001X
CA473031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice