Provider Demographics
NPI:1326073958
Name:PANDYA, SUNEN G (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUNEN
Middle Name:G
Last Name:PANDYA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8014 N LOWER SACRAMENTO RD, SUITE # B & C,
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95210-3747
Mailing Address - Country:US
Mailing Address - Phone:209-451-1133
Mailing Address - Fax:209-433-4300
Practice Address - Street 1:8014 N LOWER SACRAMENTO RD STE B&C
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210-3753
Practice Address - Country:US
Practice Address - Phone:209-451-1133
Practice Address - Fax:209-433-4300
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA508051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2958OtherDENTAL HEALTH SERVICES HM
CA57726OtherHEALTHY FAMILIES/SAFEGUAR
CA0005177OtherMANAGED DENTAL CARE
CA012887OtherPMI DELTACARE
CA10393OtherPACIFICARE DENTAL & VISIO
CA1696185OtherUNITED CONCORDIA
CA416735OtherAETNA DENTAL HMO PLAN
CA4538OtherPACIFIC UNION
CA4801OtherLIBERTY DENTAL PLAN
CA11352OtherCALIFORNIA DENTAL SERVICE
CA57565OtherSAFEGUARD HMO DENTAL PLAN
CA2283OtherCALIFORNIA DENTAL BENEFIT
CAF3571OtherGOLDEN WEST HMO PLAN
CAD1537OtherSMILESAVER DENTAL PLANS
CA120749-1OtherDENTAL BENEFIT PROVIDER
CA1776OtherCALIFORNIA DENTAL NETWORK
CA244931OtherUNITED DENTAL HEALTHCARE