Provider Demographics
NPI:1235272105
Name:AMANJEE, SUCHETA SARATHY (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUCHETA
Middle Name:SARATHY
Last Name:AMANJEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:790 ATLANTIC ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-1806
Mailing Address - Country:US
Mailing Address - Phone:916-780-7890
Mailing Address - Fax:916-780-5733
Practice Address - Street 1:520 COTTONWOOD ST STE 3
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3603
Practice Address - Country:US
Practice Address - Phone:530-662-7558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA535731223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry