Provider Demographics
NPI:1467625343
Name:JOSHI, SANJAY R (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANJAY
Middle Name:R
Last Name:JOSHI
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 1:18800 W 10 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2654
Mailing Address - Country:US
Mailing Address - Phone:248-569-6304
Mailing Address - Fax:248-569-7914
Practice Address - Street 1:18800 W 10 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2654
Practice Address - Country:US
Practice Address - Phone:248-569-6304
Practice Address - Fax:248-569-7914
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI183301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice