Provider Demographics
NPI:1699022400
Name:KAUR, MONINDER (DDS)
Entity Type:Individual
Prefix:
First Name:MONINDER
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MONA
Other - Middle Name:
Other - Last Name:KAUR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1207 26TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-1504
Mailing Address - Country:US
Mailing Address - Phone:650-575-8152
Mailing Address - Fax:
Practice Address - Street 1:1207 26TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-1504
Practice Address - Country:US
Practice Address - Phone:650-575-8152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61724122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist