Provider Demographics
NPI:1427388875
Name:REKHA VONTELA DDS
Entity Type:Organization
Organization Name:REKHA VONTELA DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REKHA
Authorized Official - Middle Name:
Authorized Official - Last Name:VONTELA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-754-5432
Mailing Address - Street 1:3737 LONE TREE WAY STE F
Mailing Address - Street 2:ANTIOCH CA 94509
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-6037
Mailing Address - Country:US
Mailing Address - Phone:925-754-5432
Mailing Address - Fax:925-754-0877
Practice Address - Street 1:3737 LONE TREE WAY
Practice Address - Street 2:#F
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6065
Practice Address - Country:US
Practice Address - Phone:925-754-5432
Practice Address - Fax:925-754-0877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-07
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49703122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty