Healthcare Provider Details

I. General information

NPI: 1417880873
Provider Name (Legal Business Name): CHETAN KASHINKUNTI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 AURORA CT FL 4
AURORA CO
80045-2612
US

IV. Provider business mailing address

330 COMPASS PASS
GRAND ISLAND NY
14072-2864
US

V. Phone/Fax

Practice location:
  • Phone: 303-724-7928
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number390200000X
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: