Healthcare Provider Details

I. General information

NPI: 1609826841
Provider Name (Legal Business Name): RAJESH JUDE SONDKAR DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 JOAQUIN AVE
SAN LEANDRO CA
94577-4997
US

IV. Provider business mailing address

501 BLACKSTONE CT
DANVILLE CA
94506-1341
US

V. Phone/Fax

Practice location:
  • Phone: 510-483-3800
  • Fax: 510-483-4401
Mailing address:
  • Phone: 925-648-4385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number48382
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: