Provider Demographics
NPI:1396418604
Name:ACHARYA, SONALI MARFATIA (BDS, MDS, DMD)
Entity Type:Individual
Prefix:DR
First Name:SONALI
Middle Name:MARFATIA
Last Name:ACHARYA
Suffix:
Gender:F
Credentials:BDS, MDS, DMD
Other - Prefix:
Other - First Name:SONALI
Other - Middle Name:SALIL
Other - Last Name:MARFATIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:203 TAMAL VISTA BLVD APT 202
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1657
Mailing Address - Country:US
Mailing Address - Phone:415-680-7151
Mailing Address - Fax:
Practice Address - Street 1:2285 CHALLENGER WAY
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95407-5418
Practice Address - Country:US
Practice Address - Phone:707-569-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-01
Last Update Date:2024-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1067671223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics