Provider Demographics
NPI:1235500752
Name:KOCHAREKAR, SACHIN V (DMD)
Entity Type:Individual
Prefix:
First Name:SACHIN
Middle Name:V
Last Name:KOCHAREKAR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 S SOUTHWEST LOOP 323
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-9236
Mailing Address - Country:US
Mailing Address - Phone:903-593-3333
Mailing Address - Fax:903-581-6985
Practice Address - Street 1:3310 S SOUTHWEST LOOP 323
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-9236
Practice Address - Country:US
Practice Address - Phone:903-593-3333
Practice Address - Fax:903-581-6985
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32777122300000X
NMDD4416122300000X
NH04278122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist