Provider Demographics
NPI:1003009440
Name:VONTELA, REKHA (DDS)
Entity Type:Individual
Prefix:
First Name:REKHA
Middle Name:
Last Name:VONTELA
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 1:3737 LONE TREE WAY
Mailing Address - Street 2:SUITE F
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-6065
Mailing Address - Country:US
Mailing Address - Phone:925-754-5432
Mailing Address - Fax:925-754-0877
Practice Address - Street 1:3737 LONE TREE WAY
Practice Address - Street 2:SUITE F
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6065
Practice Address - Country:US
Practice Address - Phone:925-754-5432
Practice Address - Fax:925-754-0877
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49703122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist