Provider Demographics
NPI:1003104399
Name:KAUR, SUMEET
Entity Type:Individual
Prefix:
First Name:SUMEET
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 N 8TH ST UNIT 205
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-5061
Mailing Address - Country:US
Mailing Address - Phone:510-861-8985
Mailing Address - Fax:916-624-2731
Practice Address - Street 1:4230 ROCKLIN RD STE E2
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-2869
Practice Address - Country:US
Practice Address - Phone:916-624-0676
Practice Address - Fax:916-624-2731
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60414122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist