Provider Demographics
NPI:1497950901
Name:UPADHYAYA, SWATHI (DDS)
Entity Type:Individual
Prefix:
First Name:SWATHI
Middle Name:
Last Name:UPADHYAYA
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 1:3293 MOULIN LN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95135-1065
Mailing Address - Country:US
Mailing Address - Phone:408-689-2335
Mailing Address - Fax:
Practice Address - Street 1:373 S MONROE ST STE 102
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-5125
Practice Address - Country:US
Practice Address - Phone:408-539-5378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55052122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist