MEDICARE: MOUNIKA CHAMARTHI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	111581	CA
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1093427429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOUNIKA CHAMARTHI

Provider Business Mailing Address
First Line	:	29759 HANSEN ST
Second Line	:
City	:	HAYWARD
State	:	CA
Zip	:	94544-6724
Country	:	US
Telephone Number	:	669-544-9823
Fax Number	:

Provider Business Practice Location Address
First Line	:	2140 S SHORE CTR
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501-8043
Country	:	US
Telephone Number	:	510-214-0253
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2022
Last Update Date	:	02/15/2026

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Directions to “ MOUNIKA CHAMARTHI ” Practice Location

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