Provider Demographics
NPI:1003011172
Name:KHULLAR, SONIA (DDS)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:KHULLAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SONIA
Other - Middle Name:
Other - Last Name:ARORA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BDS
Mailing Address - Street 1:132 S VERMONT AVENUE
Mailing Address - Street 2:SUITE #210
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004
Mailing Address - Country:US
Mailing Address - Phone:213-389-2625
Mailing Address - Fax:213-389-4736
Practice Address - Street 1:132 S VERMONT AVENUE
Practice Address - Street 2:SUITE #210
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004
Practice Address - Country:US
Practice Address - Phone:213-389-2625
Practice Address - Fax:213-389-4736
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45222122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG92829OtherDENTICAL
CAB45222OtherHFP