Provider Demographics
NPI:1629744826
Name:DHAMORIKAR, ANIKET (DDS)
Entity Type:Individual
Prefix:
First Name:ANIKET
Middle Name:
Last Name:DHAMORIKAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CLEMENTINA ST APT 725
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-4259
Mailing Address - Country:US
Mailing Address - Phone:909-569-7759
Mailing Address - Fax:
Practice Address - Street 1:400 CLEMENTINA ST APT 725
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4259
Practice Address - Country:US
Practice Address - Phone:909-569-7759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS106566122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist