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General NPI Number Information
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NPI Number | 1518847508
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Entity Type | Individual
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Provider Name | SITHARA SOMASEKHARAN NAIR DDS
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Gender | Female
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 401 KENILWORTH DR STE 960
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City | PETALUMA
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State | CA
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Zip | 94952-3406
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Country | US
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Telephone | 707-789-9600
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Fax | 707-789-9549
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Provider Business Mailing Address
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Address Line | 55 MARIA DR APT 112
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City | PETALUMA
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State | CA
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Zip | 94954-3500
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Country | US
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Telephone |
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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 | DDS111860
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License Number State | CA
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