Provider Demographics
NPI:1174150213
Name:DANDEKAR, ESHAN
Entity type:Individual
Prefix:
First Name:ESHAN
Middle Name:
Last Name:DANDEKAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 WESTON DR
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-3730
Mailing Address - Country:US
Mailing Address - Phone:408-813-6120
Mailing Address - Fax:
Practice Address - Street 1:120 SAN LUCAR CT
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-5213
Practice Address - Country:US
Practice Address - Phone:855-816-7705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered