Provider Demographics
NPI:1275857609
Name:BOPARAI, SHIKARAM DENTAL, INC
Entity Type:Organization
Organization Name:BOPARAI, SHIKARAM DENTAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNEET
Authorized Official - Middle Name:
Authorized Official - Last Name:BOPARAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-482-2103
Mailing Address - Street 1:12845 CUMBERLAND DR
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-3817
Mailing Address - Country:US
Mailing Address - Phone:408-482-2103
Mailing Address - Fax:408-457-7575
Practice Address - Street 1:255 CRESTVIEW DR
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-6503
Practice Address - Country:US
Practice Address - Phone:408-482-2103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-14
Last Update Date:2010-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA476911223G0001X
CA490391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty