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General NPI Number Information
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NPI Number | 1871867069
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Entity Type | Individual
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Provider Name | MONICA JETHWANI DDS
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Gender | Female
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Dates
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Enumeration Date | 03/06/2012
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 6350 TRANSIT RD
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City | DEPEW
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State | NY
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Zip | 14043-1039
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Country | US
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Telephone | 716-206-0718
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Fax |
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Provider Business Mailing Address
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Address Line | 140 GLENDON PL UNIT A
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-6092
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DE60665049
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License Number State | WA
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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 | 0401413488
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 063785
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License Number State | NY
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