Provider Demographics
NPI:1962900175
Name:SONI, KRUPA M (DDS)
Entity type:Individual
Prefix:
First Name:KRUPA
Middle Name:M
Last Name:SONI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:KRUPA
Other - Middle Name:K
Other - Last Name:MEHTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10926 BROOKLAWN RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-6628
Mailing Address - Country:US
Mailing Address - Phone:720-361-9323
Mailing Address - Fax:
Practice Address - Street 1:10926 BROOKLAWN RD
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130-6628
Practice Address - Country:US
Practice Address - Phone:720-361-9323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002034371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice