Provider Demographics
NPI:1912633439
Name:JOHAL, GURMINDER KAUR
Entity Type:Individual
Prefix:DR
First Name:GURMINDER
Middle Name:KAUR
Last Name:JOHAL
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:GURMINDER
Other - Middle Name:
Other - Last Name:KAUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:498 SAWGRASS DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-9223
Mailing Address - Country:US
Mailing Address - Phone:412-330-0787
Mailing Address - Fax:
Practice Address - Street 1:DENTAL DREAMS
Practice Address - Street 2:3890 DIXIE HIGHWAY SUITE #1A
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601
Practice Address - Country:US
Practice Address - Phone:412-330-0787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016013341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice