Provider Demographics
NPI:1295275758
Name:SONI, ANJALI (DDS)
Entity type:Individual
Prefix:
First Name:ANJALI
Middle Name:
Last Name:SONI
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 1:1910 EAST ROUTE 70, STE 9
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003
Mailing Address - Country:US
Mailing Address - Phone:856-424-5955
Mailing Address - Fax:856-424-8382
Practice Address - Street 1:1910 EAST ROUTE 70, STE 9
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003
Practice Address - Country:US
Practice Address - Phone:856-424-5955
Practice Address - Fax:856-424-8382
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-03
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0426431223P0221X
NJ22DI027661001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty