Provider Demographics
NPI:1902907132
Name:CHOHAN, SUREKHA S (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUREKHA
Middle Name:S
Last Name:CHOHAN
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 1:884 SOUTHAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-1907
Mailing Address - Country:US
Mailing Address - Phone:707-748-7600
Mailing Address - Fax:707-748-7693
Practice Address - Street 1:884 SOUTHAMPTON RD
Practice Address - Street 2:
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-1907
Practice Address - Country:US
Practice Address - Phone:707-748-7600
Practice Address - Fax:707-748-7693
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42495122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist