Provider Demographics
NPI:1174779029
Name:KALANURIA, VINITA ATUL (DDS)
Entity type:Individual
Prefix:DR
First Name:VINITA
Middle Name:ATUL
Last Name:KALANURIA
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 1:111 HIDDEN FOREST CT
Mailing Address - Street 2:
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-4107
Mailing Address - Country:US
Mailing Address - Phone:484-326-6332
Mailing Address - Fax:
Practice Address - Street 1:111 HIDDEN FOREST CT
Practice Address - Street 2:
Practice Address - City:FAIRLESS HILLS
Practice Address - State:PA
Practice Address - Zip Code:19030-4107
Practice Address - Country:US
Practice Address - Phone:484-326-6332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0376291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA985702688OtherTAX IDENTIFICATION NUMBER