Provider Demographics
NPI:1720192578
Name:BAINS, HARJOT KAUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:HARJOT
Middle Name:KAUR
Last Name:BAINS
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 1:10630 N 59TH AVE
Mailing Address - Street 2:SUITE101
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304-1239
Mailing Address - Country:US
Mailing Address - Phone:623-878-0117
Mailing Address - Fax:623-878-6396
Practice Address - Street 1:10630 N 59TH AVE
Practice Address - Street 2:SUITE101
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304-1239
Practice Address - Country:US
Practice Address - Phone:623-878-0117
Practice Address - Fax:623-878-6396
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD63871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice