Provider Demographics
NPI:1770345282
Name:K TEJ DENTAL INC
Entity type:Organization
Organization Name:K TEJ DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARANTEJ
Authorized Official - Middle Name:
Authorized Official - Last Name:KOHLI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:619-670-1706
Mailing Address - Street 1:3855 AVOCADO BLVD
Mailing Address - Street 2:SUITE# 260
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941
Mailing Address - Country:US
Mailing Address - Phone:619-670-1706
Mailing Address - Fax:
Practice Address - Street 1:3855 AVOCADO BLVD STE 260
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-8523
Practice Address - Country:US
Practice Address - Phone:619-670-1706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty