Provider Demographics
NPI:1942650973
Name:RENUKA P KUMAR DDS
Entity Type:Organization
Organization Name:RENUKA P KUMAR DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RENUKA
Authorized Official - Middle Name:PREM
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-767-6918
Mailing Address - Street 1:9295 E THUNDERBIRD RD STE 103
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-4376
Mailing Address - Country:US
Mailing Address - Phone:480-767-6918
Mailing Address - Fax:480-767-7990
Practice Address - Street 1:9295 E THUNDERBIRD RD STE 103
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-4376
Practice Address - Country:US
Practice Address - Phone:480-767-6918
Practice Address - Fax:480-767-7990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD03637261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental