Provider Demographics
NPI:1548718273
Name:SONI, VANDANA S (DDS)
Entity type:Individual
Prefix:DR
First Name:VANDANA
Middle Name:S
Last Name:SONI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12360 RICHMOND AVE
Mailing Address - Street 2:APT 431
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2421
Mailing Address - Country:US
Mailing Address - Phone:832-643-3991
Mailing Address - Fax:
Practice Address - Street 1:738 FM 1092 RD
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-5910
Practice Address - Country:US
Practice Address - Phone:281-969-8656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-11
Last Update Date:2016-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX323521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice