Provider Demographics
NPI:1144520776
Name:AMRUTE, KUNAL VINOD (DDS)
Entity type:Individual
Prefix:
First Name:KUNAL
Middle Name:VINOD
Last Name:AMRUTE
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 1:3900 WOODLAND AVE
Mailing Address - Street 2:VAMC (160)
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4551
Mailing Address - Country:US
Mailing Address - Phone:215-823-5900
Mailing Address - Fax:215-823-4288
Practice Address - Street 1:301 OXFORD VALLEY RD STE 404A
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-7710
Practice Address - Country:US
Practice Address - Phone:215-493-1616
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0389501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice