Provider Demographics
NPI:1235317033
Name:GASHPAROVA, KRASNODARA NANEVA (DDS)
Entity Type:Individual
Prefix:DR
First Name:KRASNODARA
Middle Name:NANEVA
Last Name:GASHPAROVA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:DARA
Other - Middle Name:
Other - Last Name:GASHPAROVA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:3341 THELMA ST
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-2662
Mailing Address - Country:US
Mailing Address - Phone:626-289-6131
Mailing Address - Fax:626-289-0408
Practice Address - Street 1:70 S PALM AVE
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3101
Practice Address - Country:US
Practice Address - Phone:626-289-6131
Practice Address - Fax:626-289-0408
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA534521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD53452OtherDENTI-CAL