Healthcare Provider Details

I. General information

NPI: 1275957037
Provider Name (Legal Business Name): KEVIN FURMANEK DDS, MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2014
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20406 REDWOOD RD STE C-1
CASTRO VALLEY CA
94546-4317
US

IV. Provider business mailing address

6107 HOMER CT
PLEASANTON CA
94588-3948
US

V. Phone/Fax

Practice location:
  • Phone: 510-582-7919
  • Fax:
Mailing address:
  • Phone: 916-847-3987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number170067
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: