Provider Demographics
NPI:1366673881
Name:DODSON, GEETANJALI (DO)
Entity Type:Individual
Prefix:DR
First Name:GEETANJALI
Middle Name:
Last Name:DODSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:GEETANJALI
Other - Middle Name:
Other - Last Name:MALHOTRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1643 NW 136 AVE BLDG. H STE. 100
Mailing Address - Street 2:MSC 11607-0004
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2857
Mailing Address - Country:US
Mailing Address - Phone:954-377-3071
Mailing Address - Fax:856-560-7110
Practice Address - Street 1:1005 LUJAN HILL RD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88007-6304
Practice Address - Country:US
Practice Address - Phone:575-523-4573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-2431-20207Q00000X
FLOS10744207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine