Provider Demographics
NPI:1225706559
Name:AJITSANKARDAS, POOJA (BDS,MDS,MS)
Entity Type:Individual
Prefix:
First Name:POOJA
Middle Name:
Last Name:AJITSANKARDAS
Suffix:
Gender:F
Credentials:BDS,MDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10439 EMMAS CIR N
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-4184
Mailing Address - Country:US
Mailing Address - Phone:901-236-5939
Mailing Address - Fax:
Practice Address - Street 1:875 UNION AVE COLLEGE OF DENTISTRY 5TH FLOOR SUITE S507
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38163-0001
Practice Address - Country:US
Practice Address - Phone:901-448-2827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS419521122300000X
TN11673122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist