Provider Demographics
NPI:1205004801
Name:BANERJEE, SARMISTHA (DDS)
Entity Type:Individual
Prefix:
First Name:SARMISTHA
Middle Name:
Last Name:BANERJEE
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 1:2534 WALNUT BEND LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-3013
Mailing Address - Country:US
Mailing Address - Phone:281-859-7777
Mailing Address - Fax:
Practice Address - Street 1:2534 WALNUT BEND LN
Practice Address - Street 2:SUITE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-3013
Practice Address - Country:US
Practice Address - Phone:281-859-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23495122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist