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General NPI Number Information
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NPI Number | 1477703304
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Entity Type | Individual
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Provider Name | BINDU B. KANSAGRA DDS
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Gender | Female
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Dates
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Enumeration Date | 09/29/2008
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Last Update Date | 02/06/2019
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Provider Practice Location Address
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Address Line | 14382 RED HILL AVE APT 21
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City | TUSTIN
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State | CA
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Zip | 92780-6267
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Country | US
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Telephone | 714-679-9883
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Fax |
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Provider Business Mailing Address
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Address Line | 14382 RED HILL AVE UNIT #21
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City | TUSTIN
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State | CA
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Zip | 92780
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Country | US
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Telephone | 714-679-9883
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30.025643
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 57691
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License Number State | CA
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