MEDICARE: DR. KRUNAL SHERATHIYA BDS, DDS, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	63268	CA

General Provider Information

NPI Number	:	1508265539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRUNAL SHERATHIYA BDS, DDS, MS

Provider Business Mailing Address
First Line	:	997 E CHAMPLAIN DR STE 120
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-0749
Country	:	US
Telephone Number	:	559-439-5400
Fax Number	:

Provider Business Practice Location Address
First Line	:	4220 W FIGARDEN DR STE 101
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-6071
Country	:	US
Telephone Number	:	559-439-5200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2014
Last Update Date	:	07/20/2020

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