Preethi Bangalore, DDS
Individual provider Active NPI Dentist · Cupertino, CA
NPI 1912934332 · NPPES record last updated May 15, 2024
Key facts
- NPI
- 1912934332
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 49058 (CA)
- Practice address
- 10487 S de Anza Blvd
Cupertino, CA 95014-3011 - Phone
- (408) 255-7799
- NPI assigned
- Jun 28, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49058 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| William Cox Dental Corporation | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 49058 | CA | Yes |
Addresses
Primary practice location
10487 S de Anza Blvd
Cupertino, CA 95014-3011
Mailing address
10487 S de Anza Blvd
Cupertino, CA 95014-3011
Phone (408) 255-7799
Other providers in Cupertino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.