Provider Demographics
NPI:1902396328
Name:SHEVCHUK AND KAUR GENERAL DENTAL PARTNERSHIP
Entity Type:Organization
Organization Name:SHEVCHUK AND KAUR GENERAL DENTAL PARTNERSHIP
Other - Org Name:WINDSOR DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRIY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEVCHUK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-809-1089
Mailing Address - Street 1:9025 OLD REDWOOD HWY STE A
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CA
Mailing Address - Zip Code:95492-8881
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9025 OLD REDWOOD HWY STE A
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CA
Practice Address - Zip Code:95492-8881
Practice Address - Country:US
Practice Address - Phone:707-838-3363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty