Provider Demographics
NPI:1720768740
Name:ONE MOBILE DENTAL
Entity Type:Organization
Organization Name:ONE MOBILE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUDHA
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHINTA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:510-329-5731
Mailing Address - Street 1:103 SYCAMORE VALLEY RD W
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-3957
Mailing Address - Country:US
Mailing Address - Phone:925-362-1800
Mailing Address - Fax:925-855-1160
Practice Address - Street 1:7300 SANDLAKE COMMONS BLVD STE 317
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8011
Practice Address - Country:US
Practice Address - Phone:925-362-1800
Practice Address - Fax:925-855-1160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty