MEDICARE: KIRPAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1205308764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIRPAL CORPORATION

Provider Business Mailing Address
First Line	:	8410 ARROWHEAD FARM DR
Second Line	:
City	:	BURR RIDGE
State	:	IL
Zip	:	60527-0822
Country	:	US
Telephone Number	:	631-220-7839
Fax Number	:

Provider Business Practice Location Address
First Line	:	5455 W NORTH AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60639-4346
Country	:	US
Telephone Number	:	631-220-7839
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. AMITOJ SINGH MEHTA
Credential	:	DDS MS
Telephone Number	:	631-220-7839

Provider Enumeration Date	:	12/21/2018
Last Update Date	:	12/21/2018

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Directions to “KIRPAL CORPORATION ” Practice Location

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