Provider Demographics
NPI:1992288450
Name:SHRIDHAR, PARUL (DDS)
Entity type:Individual
Prefix:DR
First Name:PARUL
Middle Name:
Last Name:SHRIDHAR
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 1:3747 CARMEL VIEW RD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-3554
Mailing Address - Country:US
Mailing Address - Phone:310-210-0301
Mailing Address - Fax:
Practice Address - Street 1:2484 VISTA WAY STE B
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-5682
Practice Address - Country:US
Practice Address - Phone:760-439-0334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103225122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist