Provider Demographics
NPI:1801549381
Name:KIRANDEEP KAUR DDS INC
Entity type:Organization
Organization Name:KIRANDEEP KAUR DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KIRANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:646-413-5840
Mailing Address - Street 1:1361 S HART DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOUSE
Mailing Address - State:CA
Mailing Address - Zip Code:95391-1483
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1222 W COLONY RD STE 140
Practice Address - Street 2:
Practice Address - City:RIPON
Practice Address - State:CA
Practice Address - Zip Code:95366-9482
Practice Address - Country:US
Practice Address - Phone:209-924-4089
Practice Address - Fax:209-924-4089
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KIRANDEEP KAUR DDS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty