Provider Demographics
NPI:1922033208
Name:SONI, VANDANA (DMD)
Entity Type:Individual
Prefix:DR
First Name:VANDANA
Middle Name:
Last Name:SONI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 EVERETT AVENUE
Mailing Address - Street 2:CHELSEA DENTAL CARE
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150
Mailing Address - Country:US
Mailing Address - Phone:617-887-9944
Mailing Address - Fax:617-887-9666
Practice Address - Street 1:61 EVERETT AVENUE
Practice Address - Street 2:CHELSEA DENTAL CARE
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150
Practice Address - Country:US
Practice Address - Phone:617-887-9944
Practice Address - Fax:617-887-9666
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN206981223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0204463Medicaid