Provider Demographics
NPI:1114201001
Name:KUNDRA, KAPIL (DMD)
Entity Type:Individual
Prefix:DR
First Name:KAPIL
Middle Name:
Last Name:KUNDRA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:776 E 3RD AVE
Mailing Address - Street 2:URBAN SMILES DENTAL PA , SUITE -LL2
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203-1698
Mailing Address - Country:US
Mailing Address - Phone:908-245-1600
Mailing Address - Fax:
Practice Address - Street 1:776 E 3RD AVE
Practice Address - Street 2:URBAN SMILES DENTAL PA , SUITE -LL2
Practice Address - City:ROSELLE
Practice Address - State:NJ
Practice Address - Zip Code:07203-1698
Practice Address - Country:US
Practice Address - Phone:908-245-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI024759001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice