Provider Demographics
NPI:1639916976
Name:SANWARIA, HIMANI
Entity type:Individual
Prefix:
First Name:HIMANI
Middle Name:
Last Name:SANWARIA
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 1:4 OLD FORGE LN
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4113
Mailing Address - Country:US
Mailing Address - Phone:857-277-4596
Mailing Address - Fax:
Practice Address - Street 1:HENRY M GOLDMAN SCHOOL OF DENTAL MEDICINE, BU
Practice Address - Street 2:635 ALBANY STREET
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:14534
Practice Address - Country:US
Practice Address - Phone:617-222-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL1000931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice