Provider Demographics
NPI:1891997698
Name:PANCHAL, PARUL JIGNESHKUMAR (DDS)
Entity Type:Individual
Prefix:DR
First Name:PARUL
Middle Name:JIGNESHKUMAR
Last Name:PANCHAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15741 WOODRUFF AVE STE A
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-4083
Mailing Address - Country:US
Mailing Address - Phone:562-866-3400
Mailing Address - Fax:562-866-3002
Practice Address - Street 1:15741 WOODRUFF AVE STE A
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-4083
Practice Address - Country:US
Practice Address - Phone:562-866-3400
Practice Address - Fax:562-866-3002
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50968122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG9391601Medicare ID - Type Unspecified