Healthcare Provider Details

I. General information

NPI: 1770034704
Provider Name (Legal Business Name): RAVINDER SINGH KUNWAR DDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2016
Last Update Date: 10/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27947 SLOAN CANYON RD
CASTAIC CA
91384-2594
US

IV. Provider business mailing address

23327 CLEARWATER LN
VALENCIA CA
91355-1627
US

V. Phone/Fax

Practice location:
  • Phone: 773-807-3290
  • Fax:
Mailing address:
  • Phone: 773-807-3290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number57701
License Number StateCA

VIII. Authorized Official

Name: DR. RAVINDER SINGH KUNWAR
Title or Position: PRESIDENT
Credential: DDS
Phone: 773-807-3290