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NPI Code Detail

MEDICARE: DR. SONIA JACOB KUNTHARA DDS

MEDICARE:  DR. SONIA JACOB KUNTHARA  DDS
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
11223G0001XGeneral Practice DentistryD010433AZ
21223G0001XGeneral Practice Dentistry37015TX

General Provider Information

NPI Number : 1770135048
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SONIA JACOB KUNTHARA DDS
Provider Business Mailing Address
First Line : 5823 S COLUMBUS CT
Second Line :
City : GILBERT
State : AZ
Zip : 85298-0326
Country : US
Telephone Number : 602-369-2178
Fax Number :
Provider Business Practice Location Address
First Line : 633 E RAY RD STE 104
Second Line :
City : GILBERT
State : AZ
Zip : 85296-4202
Country : US
Telephone Number : 480-833-0880
Fax Number : 480-833-0225
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2019
Last Update Date : 02/10/2021

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Directions to “ DR. SONIA JACOB KUNTHARA DDS” Practice Location

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