Provider Demographics
NPI:1497853725
Name:KALRA, AMIT (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMIT
Middle Name:
Last Name:KALRA
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 1:1435 S VERMONT AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-4543
Mailing Address - Country:US
Mailing Address - Phone:213-739-3096
Mailing Address - Fax:213-739-3098
Practice Address - Street 1:1435 S VERMONT AVE STE 101
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-4543
Practice Address - Country:US
Practice Address - Phone:213-739-3096
Practice Address - Fax:213-739-3098
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA542681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice