Provider Demographics
NPI:1902980931
Name:KULKARNI, KAVITA (DDS)
Entity Type:Individual
Prefix:MRS
First Name:KAVITA
Middle Name:
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 1:1717 W NORTHERN AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-5469
Mailing Address - Country:US
Mailing Address - Phone:602-861-3700
Mailing Address - Fax:602-861-3704
Practice Address - Street 1:1717 W NORTHERN AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-5469
Practice Address - Country:US
Practice Address - Phone:602-861-3700
Practice Address - Fax:602-861-3704
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ52751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice