Provider Demographics
NPI:1356028534
Name:SAHOTA, JASKARAN KAUR (DMD)
Entity type:Individual
Prefix:DR
First Name:JASKARAN
Middle Name:KAUR
Last Name:SAHOTA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 5TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUSA
Mailing Address - State:CA
Mailing Address - Zip Code:95932-2467
Mailing Address - Country:US
Mailing Address - Phone:530-458-3614
Mailing Address - Fax:
Practice Address - Street 1:360 5TH ST
Practice Address - Street 2:
Practice Address - City:COLUSA
Practice Address - State:CA
Practice Address - Zip Code:95932-2467
Practice Address - Country:US
Practice Address - Phone:530-458-3614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108916122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist