Provider Demographics
NPI:1770045601
Name:ANAND JETHANI DDS, INC.
Entity Type:Organization
Organization Name:ANAND JETHANI DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:JOGINDER
Authorized Official - Last Name:ANAND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-892-6901
Mailing Address - Street 1:2300 DURANT AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-1607
Mailing Address - Country:US
Mailing Address - Phone:510-848-4732
Mailing Address - Fax:510-848-4846
Practice Address - Street 1:2300 DURANT AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1607
Practice Address - Country:US
Practice Address - Phone:510-848-4732
Practice Address - Fax:510-848-4846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental