Provider Demographics
NPI:1962176693
Name:MOTA, ANKITA HARSHI (DMD)
Entity type:Individual
Prefix:
First Name:ANKITA HARSHI
Middle Name:
Last Name:MOTA
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 1:1201 SHORELAND DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-3036
Mailing Address - Country:US
Mailing Address - Phone:267-227-0081
Mailing Address - Fax:
Practice Address - Street 1:20395 PACIFICA DR STE 109
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-3016
Practice Address - Country:US
Practice Address - Phone:408-873-0802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-05
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1062031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice