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General NPI Number Information
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NPI Number | 1730999475
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Entity Type | Organization
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Legal Business Name | KAKUMA DENTAL P C
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 407 W OGDEN AVE
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City | WESTMONT
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State | IL
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Zip | 60559-2299
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Country | US
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Telephone | 630-241-3737
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Fax | 630-241-6894
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Provider Business Mailing Address
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Address Line | 1551 BAYOU PATH DR
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City | NAPERVILLE
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State | IL
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Zip | 60563-3496
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Country | US
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Telephone | 630-207-2758
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PRIYANKA PANDYA
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Credential | DMD
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Telephone | 630-207-2758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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