Healthcare Provider Details

I. General information

NPI: 1063110617
Provider Name (Legal Business Name): SEJAL MENGHANI DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SEJAL MENGHANI SHIRSATH

II. Dates (important events)

Enumeration Date: 02/22/2023
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 RIVERSIDE BLVD
SACRAMENTO CA
95818-2237
US

IV. Provider business mailing address

405 DAVIS CT APT 1002
SAN FRANCISCO CA
94111-2419
US

V. Phone/Fax

Practice location:
  • Phone: 916-979-5444
  • Fax:
Mailing address:
  • Phone: 609-579-3008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number112898
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: