Kunjal Patel Dental Corp

Primary specialty

DentistTaxonomy code 122300000X

License

B34037 Issued in CA

Legal business name

KUNJAL PATEL DENTAL CORP

Doing business as

Heritage Dental Group

Practice address

13677 Foothill Blvd
Suite #L
Fontana, CA 92335-0214

Phone

(909) 899-8040

Fax

(909) 463-7424

NPI assigned

Feb 21, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kunjal Patel, DDS

Title

Owner Dentist

Phone

(909) 899-8040

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heritage Dental Group Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700911922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13677 FOOTHILL BLVD",
            "address_2": "SUITE #L",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923350214",
            "telephone_number": "909-899-8040",
            "fax_number": "909-463-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13677 FOOTHILL BLVD",
            "address_2": "SUITE #L",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923350214",
            "telephone_number": "909-899-8040",
            "fax_number": "909-463-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KUNJAL PATEL DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "KUNJAL",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "909-899-8040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "B34037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL CA STATE PROGRAM",
            "identifier": "511274",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jamie L Krantzberg, PA
• Sin S. Ku, MD
• Emanuel Robert Kuenzig Jr., RN
• Gary Kukura, PA
• Jinny Y Kung, CNM
• Connie Kuykendall, PMHNP-BC
• Kwabena Osei, MD. Inc (Pediaplus)
• Christine M Kwak, MD
• Kyu B. Kwak, MD
• Sheryl Kwak, M.D.

• Dentist in Fontana, CA
• Providers in Fontana, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.