Provider Demographics
NPI:1861654337
Name:VIRK, AMRITVIR KAUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMRITVIR
Middle Name:KAUR
Last Name:VIRK
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 1:639 W GEORGIAN CT
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-3314
Mailing Address - Country:US
Mailing Address - Phone:630-222-0618
Mailing Address - Fax:
Practice Address - Street 1:33 N ADDISON RD
Practice Address - Street 2:#106
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-3875
Practice Address - Country:US
Practice Address - Phone:630-530-2224
Practice Address - Fax:630-530-2267
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019027654122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist