Provider Demographics
NPI:1184151219
Name:KABADE, DIPALEE D
Entity type:Individual
Prefix:
First Name:DIPALEE
Middle Name:D
Last Name:KABADE
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 1:9135 JUDICIAL DR APT 3318
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-4657
Mailing Address - Country:US
Mailing Address - Phone:979-571-3619
Mailing Address - Fax:
Practice Address - Street 1:9135 JUDICIAL DR APT 3318
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-4657
Practice Address - Country:US
Practice Address - Phone:979-571-3619
Practice Address - Fax:979-571-3619
Is Sole Proprietor?:No
Enumeration Date:2017-05-19
Last Update Date:2017-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101344122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist