Healthcare Provider Details

I. General information

NPI: 1891811451
Provider Name (Legal Business Name): SANDHYA NIMESH UDESHI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 MARILYN BLVD
PLAINVIEW NY
11803-1942
US

IV. Provider business mailing address

33 MARILYN BLVD
PLAINVIEW NY
11803-1942
US

V. Phone/Fax

Practice location:
  • Phone: 516-659-1167
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number050367
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN124078
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: