Provider Demographics
NPI:1538488135
Name:THANKARAJ, SOPHIA GEORGE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:GEORGE
Last Name:THANKARAJ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SOPHIA
Other - Middle Name:GERALDINE
Other - Last Name:STHAVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:6508 GLENSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-9823
Mailing Address - Country:US
Mailing Address - Phone:513-204-5556
Mailing Address - Fax:
Practice Address - Street 1:1 WYOMING ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2722
Practice Address - Country:US
Practice Address - Phone:937-208-3844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOSDB #29121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice