Healthcare Provider Details

I. General information

NPI: 1033967542
Provider Name (Legal Business Name): NAMASTE DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2024
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10169 W COLONIAL DR
OCOEE FL
34761-4209
US

IV. Provider business mailing address

10169 W COLONIAL DR
OCOEE FL
34761-4209
US

V. Phone/Fax

Practice location:
  • Phone: 321-323-6790
  • Fax:
Mailing address:
  • Phone: 321-323-6790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SUMIT SONI
Title or Position: DENTIST / OWNER
Credential: DDS
Phone: 321-323-6790