Provider Demographics
NPI:1659599280
Name:KHAIRAH, GURPREET SINGH (DDS)
Entity Type:Individual
Prefix:DR
First Name:GURPREET
Middle Name:SINGH
Last Name:KHAIRAH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8460 S EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2864
Mailing Address - Country:US
Mailing Address - Phone:702-270-0025
Mailing Address - Fax:
Practice Address - Street 1:8460 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2864
Practice Address - Country:US
Practice Address - Phone:702-270-0025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54663122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1659599280Medicaid