Provider Demographics
NPI:1033634399
Name:KATHURIA, SAKSHI
Entity Type:Individual
Prefix:
First Name:SAKSHI
Middle Name:
Last Name:KATHURIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3025 W CHRISTOFFERSEN PKWY APT K205
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-8078
Mailing Address - Country:US
Mailing Address - Phone:267-230-6488
Mailing Address - Fax:
Practice Address - Street 1:2808 W MONTE VISTA AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-8409
Practice Address - Country:US
Practice Address - Phone:209-667-2879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1016531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice