Provider Demographics
NPI:1942920186
Name:ARUN, AMBIKA
Entity Type:Individual
Prefix:
First Name:AMBIKA
Middle Name:
Last Name:ARUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4862 SWINFORD CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-7809
Mailing Address - Country:US
Mailing Address - Phone:510-709-8827
Mailing Address - Fax:
Practice Address - Street 1:4862 SWINFORD CT
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-7809
Practice Address - Country:US
Practice Address - Phone:510-709-8827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107841122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist