Provider Demographics
NPI:1649828013
Name:KUNDAPUR, VINAYA (BDS,MDS)
Entity type:Individual
Prefix:
First Name:VINAYA
Middle Name:
Last Name:KUNDAPUR
Suffix:
Gender:F
Credentials:BDS,MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8727 FREDERICKSBURG RD APT 1008
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-4319
Mailing Address - Country:US
Mailing Address - Phone:210-550-9122
Mailing Address - Fax:
Practice Address - Street 1:7703 FLOYD CURL DR # 4.430T
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3901
Practice Address - Country:US
Practice Address - Phone:210-550-9122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-29
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA30555390200000X
TX38265122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program