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Dr. Shanti Gopalan, DDS
Pediatric Dentist in San Diego, California
NPI 1003953936

Shanti Gopalan is a Pediatric Dentist based in San Diego, CA and is specialized in Pediatric Dentistry. Shanti Gopalan practices in San Diego, CA and has the professional credentials of DDS. The NPI Number for Shanti Gopalan is 1003953936 and holds a License No. 55853 (California).

The current practice location address for Shanti Gopalan is 13347 Entreken Ave, San Diego, CA and can be reached out via phone at 858-740-6977.

Location: 13347 Entreken Ave, San Diego, CA, 92129-2353
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003953936
Provider Name
Shanti Gopalan
Credential
DDS
Provider Entity Type
Individual
Gender
Female
Address
13347 Entreken Ave, San Diego, CA, 92129-2353
Phone Number
858-740-6977
Fax Number
Provider Enumeration Date
01/31/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
D7103 05 AZ
institution
Provider Business Practice Location Address Details
Address
13347 Entreken Ave
City
San Diego
State
California
Zip
92129-2353
Phone Number
858-740-6977
Fax Number
person
Provider Business Mailing Address Details
Address
13347 Entreken Ave
City
San Diego
State
California
Zip
92129-2353
Phone Number
858-740-6977
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
55853 (California)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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