Provider Demographics
NPI:1649023250
Name:KONDA, SANDEEP (DDS)
Entity type:Individual
Prefix:DR
First Name:SANDEEP
Middle Name:
Last Name:KONDA
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 1:323 ASHFORD AVE
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-2022
Mailing Address - Country:US
Mailing Address - Phone:408-750-6220
Mailing Address - Fax:
Practice Address - Street 1:6416 CARLISLE PIKE STE 500
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-2884
Practice Address - Country:US
Practice Address - Phone:717-766-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS044686122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist