Provider Demographics
NPI:1801087135
Name:CHITRE, SANJUKTA S (DDS)
Entity type:Individual
Prefix:
First Name:SANJUKTA
Middle Name:S
Last Name:CHITRE
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 1:3685 PRESTON RD
Mailing Address - Street 2:SUITE 145
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-9509
Mailing Address - Country:US
Mailing Address - Phone:972-377-5516
Mailing Address - Fax:972-377-5517
Practice Address - Street 1:3685 PRESTON RD
Practice Address - Street 2:SUITE 145
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9509
Practice Address - Country:US
Practice Address - Phone:972-377-5516
Practice Address - Fax:972-377-5517
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2013-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014117681223G0001X
TX248181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice