Healthcare Provider Details

I. General information

NPI: 1285130302
Provider Name (Legal Business Name): SONAM DODHIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2018
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 SAINT FRANCIS DR STE 411
WATERLOO IA
50702-5634
US

IV. Provider business mailing address

1472 GREENLAKE DR
AURORA IL
60502-1352
US

V. Phone/Fax

Practice location:
  • Phone: 319-272-5000
  • Fax: 319-272-5825
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD-53131
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberMD-53131
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: