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NPI Code Detail

MEDICARE: DR. MONICA JETHWANI DDS

MEDICARE: DR. MONICA JETHWANI 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
11223E0200XEndodonticsDE60665049WA
21223G0001XGeneral Practice Dentistry0401413488VA
31223E0200XEndodontics063785NY

General Provider Information

NPI Number : 1871867069
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MONICA JETHWANI DDS
Provider Business Mailing Address
First Line : 140 GLENDON PL UNIT A
Second Line :
City : WILLIAMSVILLE
State : NY
Zip : 14221-6092
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6350 TRANSIT RD
Second Line :
City : DEPEW
State : NY
Zip : 14043-1039
Country : US
Telephone Number : 716-206-0718
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2012
Last Update Date : 08/06/2025

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