Provider Demographics
NPI:1033824065
Name:KAHLON, ROOPKAMAL SINGH (DDS)
Entity Type:Individual
Prefix:
First Name:ROOPKAMAL
Middle Name:SINGH
Last Name:KAHLON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6461 CHANNING DR
Mailing Address - Street 2:
Mailing Address - City:NORTH HIGHLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:95660-4059
Mailing Address - Country:US
Mailing Address - Phone:916-495-4270
Mailing Address - Fax:
Practice Address - Street 1:9450 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-3588
Practice Address - Country:US
Practice Address - Phone:916-495-4270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108491122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist