Provider Demographics
NPI:1366468407
Name:ARITA, SANDRA MITSUKO (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:MITSUKO
Last Name:ARITA
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 1:777 CUESTA DR STE 130
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-3765
Mailing Address - Country:US
Mailing Address - Phone:650-969-1774
Mailing Address - Fax:650-969-6888
Practice Address - Street 1:777 CUESTA DR STE 130
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-3765
Practice Address - Country:US
Practice Address - Phone:650-969-1774
Practice Address - Fax:650-969-6888
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39592122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist