Provider Demographics
NPI:1609307180
Name:DHATT, NAVDEEP KAUR (DPM)
Entity Type:Individual
Prefix:
First Name:NAVDEEP
Middle Name:KAUR
Last Name:DHATT
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 SAMARITAN DR
Mailing Address - Street 2:STE 509
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-4015
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2505 SAMARITAN DR STE 509
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4015
Practice Address - Country:US
Practice Address - Phone:408-358-2666
Practice Address - Fax:408-358-7974
Is Sole Proprietor?:No
Enumeration Date:2017-03-25
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5660213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty