Provider Demographics
NPI:1649729609
Name:KULKARNI, PRATIM ARUN (DDS)
Entity type:Individual
Prefix:
First Name:PRATIM
Middle Name:ARUN
Last Name:KULKARNI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40523 IVES CT
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2515
Mailing Address - Country:US
Mailing Address - Phone:769-216-7492
Mailing Address - Fax:
Practice Address - Street 1:2454 STORY RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-1058
Practice Address - Country:US
Practice Address - Phone:408-272-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-30
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100927122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist