Provider Demographics
NPI:1831380815
Name:GREWAL, VARUNDEEP K (DDS, MPH)
Entity type:Individual
Prefix:DR
First Name:VARUNDEEP
Middle Name:K
Last Name:GREWAL
Suffix:
Gender:F
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43693 MISSION BLVD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539
Mailing Address - Country:US
Mailing Address - Phone:916-690-7181
Mailing Address - Fax:
Practice Address - Street 1:43693 MISSION BLVD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-5832
Practice Address - Country:US
Practice Address - Phone:916-690-7181
Practice Address - Fax:510-651-7502
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55942122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist