Provider Demographics
NPI:1386980589
Name:SHIKHA BANERJEE DDS INC
Entity type:Organization
Organization Name:SHIKHA BANERJEE DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIKHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANERJEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-273-0555
Mailing Address - Street 1:2097 COMPTON AVE.
Mailing Address - Street 2:BLDG 1 STE 102
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-6665
Mailing Address - Country:US
Mailing Address - Phone:951-273-0555
Mailing Address - Fax:951-273-1555
Practice Address - Street 1:2097 COMPTON AVE.
Practice Address - Street 2:BLDG 1 STE 102
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-6665
Practice Address - Country:US
Practice Address - Phone:951-273-0555
Practice Address - Fax:951-273-1555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-17
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental