Provider Demographics
NPI:1518704279
Name:KAPOOR, SONIKA
Entity type:Individual
Prefix:
First Name:SONIKA
Middle Name:
Last Name:KAPOOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 KINDERKAMACK RD UNIT 347
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-4867
Mailing Address - Country:US
Mailing Address - Phone:516-401-8111
Mailing Address - Fax:
Practice Address - Street 1:27-11 PELLACK DR
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-3723
Practice Address - Country:US
Practice Address - Phone:201-796-7171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI030385001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice