Provider Demographics
NPI:1134319379
Name:REYNOLDS, TARAN KAUR (DDS)
Entity Type:Individual
Prefix:
First Name:TARAN
Middle Name:KAUR
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:TARAN
Other - Middle Name:
Other - Last Name:KAUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:7890 HAVEN AVENUE
Mailing Address - Street 2:SUITE # 3
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730
Mailing Address - Country:US
Mailing Address - Phone:909-484-2505
Mailing Address - Fax:909-484-2507
Practice Address - Street 1:7890 HAVEN AVENUE
Practice Address - Street 2:SUITE # 3
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730
Practice Address - Country:US
Practice Address - Phone:909-484-2505
Practice Address - Fax:909-484-2507
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401411907122300000X
CA63429122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist