MEDICARE: KALPANA NIKHIL PANDYA B.D.S

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	1223G0001X	General Practice Dentistry	LGL6	MN

General Provider Information

NPI Number	:	1609172394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALPANA NIKHIL PANDYA B.D.S

Provider Business Mailing Address
First Line	:	5861 CEDAR LAKE RD S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55416-1481
Country	:	US
Telephone Number	:	763-541-6000
Fax Number	:	763-541-1076

Provider Business Practice Location Address
First Line	:	5861 CEDAR LAKE RD S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55416-1481
Country	:	US
Telephone Number	:	763-541-6000
Fax Number	:	763-541-1076

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2011
Last Update Date	:	01/28/2011

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