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General NPI Number Information
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NPI Number | 1366920662
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Entity Type | Individual
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Provider Name | SNEHA VIJAY KHERDE
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Gender | Female
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Dates
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Enumeration Date | 07/30/2018
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Last Update Date | 04/01/2022
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Provider Practice Location Address
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Address Line | 2140 S SHORE CTR
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City | ALAMEDA
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State | CA
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Zip | 94501-8043
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Country | US
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Telephone | 510-214-0253
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Fax |
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Provider Business Mailing Address
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Address Line | 385 KING AVE
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City | FREMONT
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State | CA
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Zip | 94536-1514
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Country | US
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Telephone | 408-930-2226
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 102923
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License Number State | CA
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