Provider Demographics
NPI:1518235225
Name:SONI, TEJAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:TEJAL
Middle Name:
Last Name:SONI
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 1:1390 W AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-4812
Mailing Address - Country:US
Mailing Address - Phone:248-299-8300
Mailing Address - Fax:248-299-9235
Practice Address - Street 1:1390 W AUBURN RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-4812
Practice Address - Country:US
Practice Address - Phone:248-299-8300
Practice Address - Fax:248-299-9235
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010192011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice