Provider Demographics
NPI:1912037599
Name:DHILLON, NIRLEP KAUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:NIRLEP
Middle Name:KAUR
Last Name:DHILLON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:NIRLEP
Other - Middle Name:
Other - Last Name:KAUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1584 GLORIA CIR
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-7209
Mailing Address - Country:US
Mailing Address - Phone:209-481-0706
Mailing Address - Fax:209-832-2338
Practice Address - Street 1:1170 W 11TH ST
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-3721
Practice Address - Country:US
Practice Address - Phone:209-481-0706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA547791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice