Provider Demographics
NPI:1669034351
Name:DHILLON, HARKIRAT KAUR (DDS)
Entity Type:Individual
Prefix:
First Name:HARKIRAT
Middle Name:KAUR
Last Name:DHILLON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:HARKIRAT
Other - Middle Name:KAUR
Other - Last Name:GILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1263 N ACACIA AVE
Mailing Address - Street 2:
Mailing Address - City:RIPON
Mailing Address - State:CA
Mailing Address - Zip Code:95366-9597
Mailing Address - Country:US
Mailing Address - Phone:209-380-5980
Mailing Address - Fax:
Practice Address - Street 1:15366 S HARLAN RD
Practice Address - Street 2:
Practice Address - City:LATHROP
Practice Address - State:CA
Practice Address - Zip Code:95330-8732
Practice Address - Country:US
Practice Address - Phone:209-645-0032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-02
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1039251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice