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General NPI Number Information
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NPI Number | 1326073958
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Entity Type | Individual
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Provider Name | SUNEN G PANDYA DDS
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Gender | Male
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 8014 N LOWER SACRAMENTO RD STE B&C
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City | STOCKTON
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State | CA
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Zip | 95210-3753
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Country | US
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Telephone | 209-451-1133
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Fax | 209-433-4300
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Provider Business Mailing Address
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Address Line | 8014 N LOWER SACRAMENTO RD, SUITE # B & C,
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City | STOCKTON
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State | CA
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Zip | 95210-3747
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Country | US
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Telephone | 209-451-1133
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Fax | 209-433-4300
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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 | 50805
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License Number State | CA
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