Provider Demographics
NPI:1114044070
Name:KACHGAL, SATYA N (DDS)
Entity Type:Individual
Prefix:DR
First Name:SATYA
Middle Name:N
Last Name:KACHGAL
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 1:3625 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:STE. 8
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-3509
Mailing Address - Country:US
Mailing Address - Phone:310-603-1371
Mailing Address - Fax:
Practice Address - Street 1:3625 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:STE. 8
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-3509
Practice Address - Country:US
Practice Address - Phone:310-603-1371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33204122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist