Provider Demographics
NPI:1609443712
Name:KANSAGRA, PARTH PARIMAL (DMD)
Entity Type:Individual
Prefix:DR
First Name:PARTH
Middle Name:PARIMAL
Last Name:KANSAGRA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5807 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-6532
Mailing Address - Country:US
Mailing Address - Phone:909-450-6622
Mailing Address - Fax:
Practice Address - Street 1:5807 PINE AVE
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-6532
Practice Address - Country:US
Practice Address - Phone:909-450-6622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106198122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist