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NPI Code Detail

MEDICARE: EKTA S GHETIA DMD

MEDICARE: EKTA S GHETIA DMD
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
1122300000XDentistDDS106560CA

General Provider Information

NPI Number : 1780350884
Entity Type Code : Individual
Provider Name (Legal Business Name) : EKTA S GHETIA DMD
Provider Business Mailing Address
First Line : 310 CRESCENT VILLAGE CIR UNIT 1220
Second Line :
City : SAN JOSE
State : CA
Zip : 95134-3041
Country : US
Telephone Number : 347-257-6414
Fax Number :
Provider Business Practice Location Address
First Line : 4205 SAN FELIPE RD STE 200
Second Line :
City : SAN JOSE
State : CA
Zip : 95135-1546
Country : US
Telephone Number : 408-270-4333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2021
Last Update Date : 08/18/2021

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Directions to “ EKTA S GHETIA DMD” Practice Location

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