Provider Demographics
NPI:1346094174
Name:KADAKIA, KUNAL N (DMD)
Entity Type:Individual
Prefix:
First Name:KUNAL
Middle Name:N
Last Name:KADAKIA
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 1:2929 WALNUT ST APT 4122
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5093
Mailing Address - Country:US
Mailing Address - Phone:732-986-5072
Mailing Address - Fax:
Practice Address - Street 1:511 E 3RD ST STE 260
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-2072
Practice Address - Country:US
Practice Address - Phone:484-526-2460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA4845262460122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist