Provider Demographics
NPI:1518057652
Name:SANKAR, VIDYA (DMD MHS)
Entity Type:Individual
Prefix:DR
First Name:VIDYA
Middle Name:
Last Name:SANKAR
Suffix:
Gender:F
Credentials:DMD MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 TREMONT ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02120-1613
Mailing Address - Country:US
Mailing Address - Phone:617-732-6974
Mailing Address - Fax:617-232-8970
Practice Address - Street 1:1620 TREMONT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02120-1613
Practice Address - Country:US
Practice Address - Phone:617-732-6974
Practice Address - Fax:617-232-8970
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF21892122300000X
MADN1857437122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist