Healthcare Provider Details

I. General information

NPI: 1356991038
Provider Name (Legal Business Name): AULAKH DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2019
Last Update Date: 09/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2195 MONTEREY HWY STE 30
SAN JOSE CA
95125-1069
US

IV. Provider business mailing address

2195 MONTEREY HWY STE 30
SAN JOSE CA
95125-1069
US

V. Phone/Fax

Practice location:
  • Phone: 408-202-4824
  • Fax:
Mailing address:
  • Phone: 408-295-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. NAVDEEP AULAKH
Title or Position: PRESIDENT
Credential: DDS
Phone: 408-202-4824