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General NPI Number Information
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NPI Number | 1104077429
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Entity Type | Individual
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Provider Name | SOGINI MARIAM MATHEW DDS
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Gender | Female
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Dates
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Enumeration Date | 10/06/2008
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Last Update Date | 07/03/2018
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Provider Practice Location Address
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Address Line | 2100 HEDGCOXE RD STE 170
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City | PLANO
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State | TX
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Zip | 75025
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Country | US
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Telephone | 972-517-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 1128 NICK CIR
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City | ALLEN
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State | TX
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Zip | 75013-3353
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Country | US
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Telephone | 516-477-7208
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 054061-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 27340
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License Number State | TX
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