Provider Demographics
NPI:1144716200
Name:MOTWANI, SONIA (DDS)
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:MOTWANI
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 1:319 E MIDDLE COUNTRY RD STE 6
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2819
Mailing Address - Country:US
Mailing Address - Phone:631-724-0455
Mailing Address - Fax:
Practice Address - Street 1:319 E MIDDLE COUNTRY RD STE 6
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2819
Practice Address - Country:US
Practice Address - Phone:631-724-0455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-02
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DR032711223G0001X
NY0610071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty