Provider Demographics
NPI:1417143868
Name:KUNDRA, DARPAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARPAN
Middle Name:
Last Name:KUNDRA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6248 PEBBLE BEACH DR
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-6300
Mailing Address - Country:US
Mailing Address - Phone:707-694-8978
Mailing Address - Fax:
Practice Address - Street 1:2121 REDWOOD ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-3603
Practice Address - Country:US
Practice Address - Phone:707-644-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA558711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice