Provider Demographics
NPI:1508224080
Name:BAL, HARPRIYA KAUR (DMD)
Entity Type:Individual
Prefix:
First Name:HARPRIYA
Middle Name:KAUR
Last Name:BAL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 CRESCENT VILLAGE CIR
Mailing Address - Street 2:APT 1437
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-3047
Mailing Address - Country:US
Mailing Address - Phone:916-335-1190
Mailing Address - Fax:
Practice Address - Street 1:6766 BERNAL AVE
Practice Address - Street 2:STE 560
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-1233
Practice Address - Country:US
Practice Address - Phone:925-461-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-29
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA100462122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program