Provider Demographics
NPI:1851732010
Name:KUNTAL S PANDIT DMD PC
Entity Type:Organization
Organization Name:KUNTAL S PANDIT DMD PC
Other - Org Name:INVERNESS SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHIVANI
Authorized Official - Middle Name:K
Authorized Official - Last Name:PANDIT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:205-995-3989
Mailing Address - Street 1:5291 VALLEYDALE RD
Mailing Address - Street 2:SUITE 129
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7705
Mailing Address - Country:US
Mailing Address - Phone:205-995-3989
Mailing Address - Fax:205-995-3990
Practice Address - Street 1:5291 VALLEYDALE RD
Practice Address - Street 2:SUITE 129
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-7705
Practice Address - Country:US
Practice Address - Phone:205-995-3989
Practice Address - Fax:205-995-3990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL45371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty