Provider Demographics
NPI:1629702667
Name:TALEGAONKAR, SONIA SHANTARAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:SHANTARAM
Last Name:TALEGAONKAR
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 1:4509 AUGUSTA AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3723
Mailing Address - Country:US
Mailing Address - Phone:804-938-6173
Mailing Address - Fax:
Practice Address - Street 1:43 W WILLIAMSBURG RD
Practice Address - Street 2:
Practice Address - City:SANDSTON
Practice Address - State:VA
Practice Address - Zip Code:23150-2040
Practice Address - Country:US
Practice Address - Phone:804-737-7402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401417985122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist