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General NPI Number Information
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NPI Number | 1760812119
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Entity Type | Organization
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Legal Business Name | D. KUNDRA D.D.S. INC
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Dates
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Enumeration Date | 11/22/2013
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Last Update Date | 11/22/2013
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Provider Practice Location Address
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Address Line | 70 N EL CAMINO REAL SUITE B
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City | SAN MATEO
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State | CA
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Zip | 94401-7500
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Country | US
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Telephone | 650-685-1400
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Fax | 650-685-1401
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Provider Business Mailing Address
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Address Line | 6248 PEBBLE BEACH DR
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City | VALLEJO
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State | CA
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Zip | 94591-6300
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Country | US
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Telephone | 650-274-6754
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Fax | 650-685-1401
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. DARPAN KUNDRA
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Credential | DDS
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Telephone | 650-274-6754
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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 | 55871
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License Number State | CA
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