Healthcare Provider Details

I. General information

NPI: 1467057190
Provider Name (Legal Business Name): NEHA MILIND TAMHANE DDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2020
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 WOODSIDE RD
REDWOOD CITY CA
94061
US

IV. Provider business mailing address

434 JUDAH STREET
SAN FRANCISCO CA
94122
US

V. Phone/Fax

Practice location:
  • Phone: 650-365-8982
  • Fax:
Mailing address:
  • Phone: 310-359-2077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number105840
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: