Provider Demographics
NPI:1508265539
Name:SHERATHIYA, KRUNAL (BDS, DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:KRUNAL
Middle Name:
Last Name:SHERATHIYA
Suffix:
Gender:M
Credentials:BDS, DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:997 E CHAMPLAIN DR STE 120
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0749
Mailing Address - Country:US
Mailing Address - Phone:559-439-5400
Mailing Address - Fax:
Practice Address - Street 1:4220 W FIGARDEN DR STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-6071
Practice Address - Country:US
Practice Address - Phone:559-439-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63268122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist