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General NPI Number Information
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NPI Number | 1518576933
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Entity Type | Individual
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Provider Name | SONAM BANSAL
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Gender | Female
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Dates
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Enumeration Date | 07/31/2020
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 500 N SEMORAN BLVD STE 102
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City | ORLANDO
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State | FL
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Zip | 32807-3381
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Country | US
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Telephone | 407-277-6272
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Fax |
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Provider Business Mailing Address
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Address Line | 12368 STATE ROAD 535 #249
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City | ORLANDO
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State | FL
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Zip | 32836
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Country | US
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Telephone | 773-899-2917
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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 | DN25757
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License Number State | FL
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