Provider Demographics
NPI:1790979995
Name:BELANI, KISHORE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KISHORE
Middle Name:
Last Name:BELANI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 E DOWNER PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505
Mailing Address - Country:US
Mailing Address - Phone:530-859-8686
Mailing Address - Fax:630-859-8684
Practice Address - Street 1:57 E DOWNER PL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505
Practice Address - Country:US
Practice Address - Phone:530-859-8686
Practice Address - Fax:630-859-8684
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19A15182122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist