Provider Demographics
NPI:1184271470
Name:PATIDAR, SONIYA (DMD)
Entity type:Individual
Prefix:DR
First Name:SONIYA
Middle Name:
Last Name:PATIDAR
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 1:1426 COLE LN
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91784-8066
Mailing Address - Country:US
Mailing Address - Phone:510-589-0765
Mailing Address - Fax:
Practice Address - Street 1:41990 COOK ST STE D402
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-6102
Practice Address - Country:US
Practice Address - Phone:760-340-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1043501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice