Provider Demographics
NPI:1275691735
Name:KUMAR, PREETI (DDS)
Entity Type:Individual
Prefix:DR
First Name:PREETI
Middle Name:
Last Name:KUMAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 BLACK MOUNTAIN CIR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-6578
Mailing Address - Country:US
Mailing Address - Phone:510-494-9488
Mailing Address - Fax:
Practice Address - Street 1:39275 CEDAR BLVD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-5007
Practice Address - Country:US
Practice Address - Phone:510-608-5810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49569122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist