Healthcare Provider Details

I. General information

NPI: 1689909798
Provider Name (Legal Business Name): SONI PRASAD BDS, MS, FACP, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2009
Last Update Date: 11/03/2023
Certification Date: 11/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 DENTAL CIRCLE BRAUER HALL RM-343
CHAPEL HILL NC
27599-3402
US

IV. Provider business mailing address

140 DENTAL CIR
CHAPEL HILL NC
27599-5021
US

V. Phone/Fax

Practice location:
  • Phone: 919-537-3963
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number13530
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: