Healthcare Provider Details

I. General information

NPI: 1619761202
Provider Name (Legal Business Name): NEEKITA RAMJU SAUDAGAR DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17820 MORO RD
PRUNEDALE CA
93907-8564
US

IV. Provider business mailing address

1110 VINTAGE LN # G200
MORGAN HILL CA
95037-9763
US

V. Phone/Fax

Practice location:
  • Phone: 831-663-2660
  • Fax:
Mailing address:
  • Phone: 352-870-1585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number112713
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: