Provider Demographics
NPI:1609172394
Name:PANDYA, KALPANA NIKHIL (BDS)
Entity Type:Individual
Prefix:
First Name:KALPANA
Middle Name:NIKHIL
Last Name:PANDYA
Suffix:
Gender:F
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5861 CEDAR LAKE RD S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1481
Mailing Address - Country:US
Mailing Address - Phone:763-541-6000
Mailing Address - Fax:763-541-1076
Practice Address - Street 1:5861 CEDAR LAKE RD S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55416-1481
Practice Address - Country:US
Practice Address - Phone:763-541-6000
Practice Address - Fax:763-541-1076
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLGL61223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice