1568710069 NPI number — N.S. KHURANA III, D.M.D., P.L.L.C.

Table of content: (NPI 1568710069)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568710069 NPI number — N.S. KHURANA III, D.M.D., P.L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
N.S. KHURANA III, D.M.D., P.L.L.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568710069
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/15/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2802 W. NOB HILL BLVD.
Provider Second Line Business Mailing Address:
STE. A
Provider Business Mailing Address City Name:
YAKIMA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-576-0600
Provider Business Mailing Address Fax Number:
509-834-2311

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2802 W. NOB HILL BLVD.
Provider Second Line Business Practice Location Address:
STE. A
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-576-0600
Provider Business Practice Location Address Fax Number:
509-834-2311
Provider Enumeration Date:
08/15/2012

Additional Information

Authorized Official

Authorized Official Last Name:
KHURANA
Authorized Official First Name:
NAVJOT
Authorized Official Middle Name:
S.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
509-576-0600

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  DE00009717 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com