Provider Demographics
NPI:1467892141
Name:SANDOZI, NADIA (DDS)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:SANDOZI
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 1:8017 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55438-1179
Mailing Address - Country:US
Mailing Address - Phone:917-447-3819
Mailing Address - Fax:
Practice Address - Street 1:8017 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55438-1179
Practice Address - Country:US
Practice Address - Phone:917-447-3819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055289122300000X
MND12999122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist