Provider Demographics
NPI:1023259694
Name:KULANDAIVELU, KALAIVANI K (DDS)
Entity type:Individual
Prefix:DR
First Name:KALAIVANI
Middle Name:K
Last Name:KULANDAIVELU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KALAI
Other - Middle Name:
Other - Last Name:KULANDAIVELU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:990 W FREMONT AVE
Mailing Address - Street 2:SUITE Y
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-3021
Mailing Address - Country:US
Mailing Address - Phone:408-735-7161
Mailing Address - Fax:408-735-7173
Practice Address - Street 1:990 W FREMONT AVE
Practice Address - Street 2:SUITE Y
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3021
Practice Address - Country:US
Practice Address - Phone:408-735-7161
Practice Address - Fax:408-735-7173
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA447211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice