Provider Demographics
NPI:1467821785
Name:KUMAR, GULSHAN (DDS)
Entity Type:Individual
Prefix:
First Name:GULSHAN
Middle Name:
Last Name:KUMAR
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 1:7760 BRENTWOOD BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-1062
Mailing Address - Country:US
Mailing Address - Phone:510-786-7021
Mailing Address - Fax:
Practice Address - Street 1:7760 BRENTWOOD BLVD STE A
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-1062
Practice Address - Country:US
Practice Address - Phone:510-786-7021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64990122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist