Provider Demographics
NPI:1285158188
Name:MIRCHANDANI, SNEHA (DDS)
Entity type:Individual
Prefix:DR
First Name:SNEHA
Middle Name:
Last Name:MIRCHANDANI
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 1:7800 EL CAMINO REAL APT 3132
Mailing Address - Street 2:
Mailing Address - City:COLMA
Mailing Address - State:CA
Mailing Address - Zip Code:94014-3182
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1208 FITZGERALD DR
Practice Address - Street 2:
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2252
Practice Address - Country:US
Practice Address - Phone:510-210-8907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1017551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice