Provider Demographics
NPI:1568709558
Name:KUMAR, MEENAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:MEENAL
Middle Name:
Last Name:KUMAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 LOWES BLVD # 100
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-5491
Mailing Address - Country:US
Mailing Address - Phone:254-449-8163
Mailing Address - Fax:
Practice Address - Street 1:1100 LOWES BLVD # 100
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-5491
Practice Address - Country:US
Practice Address - Phone:254-449-8163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7011-151223G0001X
TX314691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice