Healthcare Provider Details

I. General information

NPI: 1154632354
Provider Name (Legal Business Name): KAUSHAL PRAVIN KAPADIA DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 CINEMA DR
YORK PA
17402-2656
US

IV. Provider business mailing address

35 CINEMA DR
YORK PA
17402-2656
US

V. Phone/Fax

Practice location:
  • Phone: 717-822-0272
  • Fax: 717-822-0274
Mailing address:
  • Phone: 717-822-0272
  • Fax: 717-822-0274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number14528
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS038321
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: