1326073958 NPI number — DR. SUNEN G PANDYA DDS

Table of content: DR. SUNEN G PANDYA DDS (NPI 1326073958)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326073958 NPI number — DR. SUNEN G PANDYA DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PANDYA
Provider First Name:
SUNEN
Provider Middle Name:
G
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326073958
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/29/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8014 N LOWER SACRAMENTO RD, SUITE # B & C,
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STOCKTON
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95210-3747
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
209-451-1133
Provider Business Mailing Address Fax Number:
209-433-4300

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8014 N LOWER SACRAMENTO RD STE B&C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STOCKTON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95210-3753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-451-1133
Provider Business Practice Location Address Fax Number:
209-433-4300
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  50805 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2958 . This is a "DENTAL HEALTH SERVICES HM" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 57726 . This is a "HEALTHY FAMILIES/SAFEGUAR" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 0005177 . This is a "MANAGED DENTAL CARE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 012887 . This is a "PMI DELTACARE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 10393 . This is a "PACIFICARE DENTAL & VISIO" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1696185 . This is a "UNITED CONCORDIA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 416735 . This is a "AETNA DENTAL HMO PLAN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 4538 . This is a "PACIFIC UNION" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 4801 . This is a "LIBERTY DENTAL PLAN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 11352 . This is a "CALIFORNIA DENTAL SERVICE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 57565 . This is a "SAFEGUARD HMO DENTAL PLAN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 2283 . This is a "CALIFORNIA DENTAL BENEFIT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: F3571 . This is a "GOLDEN WEST HMO PLAN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: D1537 . This is a "SMILESAVER DENTAL PLANS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 120749-1 . This is a "DENTAL BENEFIT PROVIDER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1776 . This is a "CALIFORNIA DENTAL NETWORK" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 244931 . This is a "UNITED DENTAL HEALTHCARE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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