Healthcare Provider Details

I. General information

NPI: 1255091948
Provider Name (Legal Business Name): RINKU KHULLAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2021
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4515 FARMSTEAD DR
CUMMING GA
30040-8031
US

IV. Provider business mailing address

4515 FARMSTEAD DR
CUMMING GA
30040-8031
US

V. Phone/Fax

Practice location:
  • Phone: 786-599-8770
  • Fax:
Mailing address:
  • Phone: 305-930-5583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberDN122560
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberDN122560
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN122560
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: