Provider Demographics
NPI:1205250891
Name:KAHLON, GAGANDEEP S (DDS)
Entity type:Individual
Prefix:
First Name:GAGANDEEP
Middle Name:S
Last Name:KAHLON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 WEST LOOP S STE 650
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2997
Mailing Address - Country:US
Mailing Address - Phone:713-457-3445
Mailing Address - Fax:
Practice Address - Street 1:1997 KATY MILLS BLVD
Practice Address - Street 2:#500
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-4958
Practice Address - Country:US
Practice Address - Phone:713-457-3445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX296941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice