Provider Demographics
NPI:1437728730
Name:KOONER, TAJ PREET (DDS)
Entity type:Individual
Prefix:DR
First Name:TAJ
Middle Name:PREET
Last Name:KOONER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7139 WURZBACH RD APT 1414
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1797
Mailing Address - Country:US
Mailing Address - Phone:734-740-9126
Mailing Address - Fax:
Practice Address - Street 1:10049 LEMON CREEK BLVD
Practice Address - Street 2:STE 110
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78006
Practice Address - Country:US
Practice Address - Phone:830-341-5651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX381951223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty