Healthcare Provider Details

I. General information

NPI: 1699172411
Provider Name (Legal Business Name): SANGITA TEJAS DOSHI, DDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2014
Last Update Date: 11/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10632 LITTLE PATUXENT PKWY SUITE 337
COLUMBIA MD
21044-3273
US

IV. Provider business mailing address

10632 LITTLE PATUXENT PKWY SUITE 337
COLUMBIA MD
21044-3273
US

V. Phone/Fax

Practice location:
  • Phone: 410-740-0144
  • Fax: 443-789-5757
Mailing address:
  • Phone: 410-740-0144
  • Fax: 443-789-5757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number13701
License Number StateMD

VIII. Authorized Official

Name: DR. SANGITA DOSHI
Title or Position: PEDIATRIC DENTIST
Credential: DDS
Phone: 410-740-0144