Provider Demographics
NPI:1306552757
Name:CHAUDHARY, RUPANZAL (DDS)
Entity type:Individual
Prefix:
First Name:RUPANZAL
Middle Name:
Last Name:CHAUDHARY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:RUPANZAL
Other - Middle Name:
Other - Last Name:CHAUDHARY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:310 CRESCENT VILLAGE CIR UNIT 1313
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-3036
Mailing Address - Country:US
Mailing Address - Phone:408-806-5697
Mailing Address - Fax:
Practice Address - Street 1:689 E REMINGTON DR STE A
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-1979
Practice Address - Country:US
Practice Address - Phone:408-739-6520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107134122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist