MEDICARE: UDEEKSHA NANGIA SANKARAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DDS102914	CA

General Provider Information

NPI Number	:	1205421559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UDEEKSHA NANGIA SANKARAN

Provider Business Mailing Address
First Line	:	723 JACKSON ST
Second Line	:
City	:	ALBANY
State	:	CA
Zip	:	94706-1134
Country	:	US
Telephone Number	:	510-697-2191
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 SUTTER ST RM 2536
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94108-4204
Country	:	US
Telephone Number	:	415-948-7905
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2021
Last Update Date	:	03/08/2021

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Directions to “ UDEEKSHA NANGIA SANKARAN ” Practice Location

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