Healthcare Provider Details

I. General information

NPI: 1568253144
Provider Name (Legal Business Name): PREETI CHITGOPEKAR DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 CROW CANYON PL STE 195
SAN RAMON CA
94583-1144
US

IV. Provider business mailing address

3130 CROW CANYON PL STE 195
SAN RAMON CA
94583-1144
US

V. Phone/Fax

Practice location:
  • Phone: 925-838-8166
  • Fax: 925-658-3437
Mailing address:
  • Phone: 925-838-8166
  • Fax: 925-658-3437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. PREETI SUNIL CHITGOPEKAR
Title or Position: PRESIDENT
Credential: DDS
Phone: 925-963-3990