Provider Demographics
NPI:1336574557
Name:YADAV, KALPANA
Entity Type:Individual
Prefix:DR
First Name:KALPANA
Middle Name:
Last Name:YADAV
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 1:2641 HAMNER AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-3637
Mailing Address - Country:US
Mailing Address - Phone:951-739-7770
Mailing Address - Fax:
Practice Address - Street 1:2641 HAMNER AVE STE 101
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-3637
Practice Address - Country:US
Practice Address - Phone:951-739-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-06
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0240841223G0001X
CA106008122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice