Healthcare Provider Details

I. General information

NPI: 1669328340
Provider Name (Legal Business Name): AMRITA PAWAR DDS CANDIDATE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 03/06/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2380 MONUMENT BLVD STE F
PLEASANT HILL CA
94523-3972
US

IV. Provider business mailing address

1222 HARRISON ST APT 2312
SAN FRANCISCO CA
94103-4470
US

V. Phone/Fax

Practice location:
  • Phone: 925-363-4455
  • Fax: 925-363-4571
Mailing address:
  • Phone: 415-505-1115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: