Provider Demographics
NPI:1568710069
Name:N.S. KHURANA III, D.M.D., P.L.L.C.
Entity Type:Organization
Organization Name:N.S. KHURANA III, D.M.D., P.L.L.C.
Other - Org Name:YAKIMA DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAVJOT
Authorized Official - Middle Name:S
Authorized Official - Last Name:KHURANA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:509-576-0600
Mailing Address - Street 1:2802 W. NOB HILL BLVD.
Mailing Address - Street 2:STE. A
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902
Mailing Address - Country:US
Mailing Address - Phone:509-576-0600
Mailing Address - Fax:509-834-2311
Practice Address - Street 1:2802 W. NOB HILL BLVD.
Practice Address - Street 2:STE. A
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902
Practice Address - Country:US
Practice Address - Phone:509-576-0600
Practice Address - Fax:509-834-2311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000097171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty