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General NPI Number Information
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NPI Number | 1770914236
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Entity Type | Organization
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Legal Business Name | KAMLESH JINJUWADIA D.D.S., INC
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Dates
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Enumeration Date | 12/10/2013
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Last Update Date | 12/10/2013
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Provider Practice Location Address
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Address Line | 1807 SANTA RITA RD STE C
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City | PLEASANTON
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State | CA
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Zip | 94566-4744
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Country | US
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Telephone | 925-523-3450
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Fax | 925-523-3440
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Provider Business Mailing Address
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Address Line | 1807 SANTA RITA RD STE C
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City | PLEASANTON
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State | CA
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Zip | 94566-4744
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Country | US
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Telephone | 925-523-3450
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Fax | 925-523-3440
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Authorized Official
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Title or Position | OWNER
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Name | DR. KAMLESH R JINJUWADIA
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Credential | D.D.S.
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Telephone | 925-523-3450
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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 | 41426
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License Number State | CA
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