Provider Demographics
NPI:1619543162
Name:DR RITA S MITBAVKAR DDS INC
Entity Type:Organization
Organization Name:DR RITA S MITBAVKAR DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MITBAVKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-732-5300
Mailing Address - Street 1:6134 CAMINO VERDE DR STE G
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1431
Mailing Address - Country:US
Mailing Address - Phone:408-226-1600
Mailing Address - Fax:408-226-1670
Practice Address - Street 1:717 E EL CAMINO REAL STE 7
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-2963
Practice Address - Country:US
Practice Address - Phone:408-732-5300
Practice Address - Fax:408-732-5301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty