Healthcare Provider Details

I. General information

NPI: 1871153460
Provider Name (Legal Business Name): ANEESHA RAO AMARNATH DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10393 TORRE AVE STE L
CUPERTINO CA
95014-3235
US

IV. Provider business mailing address

2520 WARBURTON AVE
SANTA CLARA CA
95051-2423
US

V. Phone/Fax

Practice location:
  • Phone: 408-446-4353
  • Fax: 408-446-4951
Mailing address:
  • Phone: 408-309-4007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDDS105851
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: