Provider Demographics
NPI:1275310781
Name:KAUR, MANMIT (DDS)
Entity Type:Individual
Prefix:DR
First Name:MANMIT
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:RUBY
Other - Middle Name:MANMIT
Other - Last Name:KAUR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DENTIST
Mailing Address - Street 1:955 LYNN DR
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-1221
Mailing Address - Country:US
Mailing Address - Phone:917-480-6499
Mailing Address - Fax:
Practice Address - Street 1:520 WEST AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-4034
Practice Address - Country:US
Practice Address - Phone:203-939-1460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT13891122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist