Provider Demographics
NPI:1447761622
Name:GUJRAL, HARVEEN KAUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:HARVEEN
Middle Name:KAUR
Last Name:GUJRAL
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 1:289 CHENANGO ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-2312
Mailing Address - Country:US
Mailing Address - Phone:607-217-7123
Mailing Address - Fax:607-217-7123
Practice Address - Street 1:289 CHENANGO ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-2312
Practice Address - Country:US
Practice Address - Phone:607-217-7123
Practice Address - Fax:607-217-7123
Is Sole Proprietor?:No
Enumeration Date:2017-10-16
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0595031223G0001X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice