Provider Demographics
NPI:1720433824
Name:DOSHI, DIVYA (DDS)
Entity Type:Individual
Prefix:
First Name:DIVYA
Middle Name:
Last Name:DOSHI
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 1:415 N MARY AVE STE 114
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-4189
Mailing Address - Country:US
Mailing Address - Phone:408-739-0093
Mailing Address - Fax:
Practice Address - Street 1:415 N MARY AVE STE 114
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-4189
Practice Address - Country:US
Practice Address - Phone:408-739-0093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39626122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist