Provider Demographics
NPI:1245951821
Name:RANDHAWA-KOHLI, RAMANPREET KAUR (DDS)
Entity type:Individual
Prefix:DR
First Name:RAMANPREET
Middle Name:KAUR
Last Name:RANDHAWA-KOHLI
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 1:2075 S PALMETTO AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH DAYTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32119-2224
Mailing Address - Country:US
Mailing Address - Phone:386-383-3717
Mailing Address - Fax:
Practice Address - Street 1:464 S RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-4928
Practice Address - Country:US
Practice Address - Phone:386-255-8866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN273641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice