Provider Demographics
NPI:1366022618
Name:KARANVEER DHILLON DDS INC
Entity Type:Organization
Organization Name:KARANVEER DHILLON DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KARANVEER
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:DHILLON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-787-2807
Mailing Address - Street 1:1136 BRETON DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-1897
Mailing Address - Country:US
Mailing Address - Phone:925-787-2807
Mailing Address - Fax:
Practice Address - Street 1:21 W PLYMOUTH HWY
Practice Address - Street 2:
Practice Address - City:IONE
Practice Address - State:CA
Practice Address - Zip Code:95640-9598
Practice Address - Country:US
Practice Address - Phone:925-787-2807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental