Gopalan, Shanti

Gopalan, Shanti is an individual health care provider with primary practice located at 13347 Entreken Ave , San Diego CA 92129-2353. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Gopalan, Shanti can be contacted via phone (858) 740-6977.

Contact Information

Primary practice address
13347 Entreken Ave San Diego CA 92129-2353
Phone: (858) 740-6977
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 55853 California

Profile Details

NPI number 1003953936
LBN Legal business name Gopalan, Shanti
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2007
Last updated Mar 17th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003953936 NPPES
Arizona MEDICAID D7103

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