Provider Demographics
NPI:1013358340
Name:KAUR, PAWANDEEP (DDS)
Entity Type:Individual
Prefix:
First Name:PAWANDEEP
Middle Name:
Last Name:KAUR
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 1:1107 SW GRADY WAY STE 250
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-5209
Mailing Address - Country:US
Mailing Address - Phone:425-687-8860
Mailing Address - Fax:425-687-8863
Practice Address - Street 1:1107 SW GRADY WAY STE 250
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5209
Practice Address - Country:US
Practice Address - Phone:425-687-8860
Practice Address - Fax:425-687-8863
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60392137122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist