Provider Demographics
NPI:1336900711
Name:TARAN KAUR REYNOLDS DDS INC
Entity Type:Organization
Organization Name:TARAN KAUR REYNOLDS DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TARAN
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-251-0408
Mailing Address - Street 1:224 E BASE LINE RD
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-3506
Mailing Address - Country:US
Mailing Address - Phone:909-874-4699
Mailing Address - Fax:
Practice Address - Street 1:1045 ATLANTIC AVE STE 602
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3419
Practice Address - Country:US
Practice Address - Phone:562-435-5388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TARAN KAUR REYNOLDS DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty