Provider Demographics
NPI:1023575602
Name:TANUJA SUNIL GOSAVI DDS INC
Entity Type:Organization
Organization Name:TANUJA SUNIL GOSAVI DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TANUJA
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOSAVI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-375-7309
Mailing Address - Street 1:4906 EL CAMINO REAL STE 1
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1451
Mailing Address - Country:US
Mailing Address - Phone:650-960-0156
Mailing Address - Fax:650-960-1248
Practice Address - Street 1:4906 EL CAMINO REAL STE 1
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-1451
Practice Address - Country:US
Practice Address - Phone:650-960-0156
Practice Address - Fax:650-960-1248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental