Sukhjeet Kaur, DDS
Individual provider Active NPI Dentist · Pine Grove, CA
NPI 1104104439 · NPPES record last updated Aug 1, 2013
Key facts
- NPI
- 1104104439
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 60389 (CA)
- Practice address
- 13828 Gold Mine Rd Ste 6
Pine Grove, CA 95665-9494 - Phone
- (631) 838-0855
- NPI assigned
- Aug 3, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60389 | CA | MD | Dental Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| S Kaur DDS Inc | Dentist | Current | Accepting new patients |
| S Kaur DDS Inc. | Dentist | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 60389 | CA | Yes |
Addresses
Primary practice location
13828 Gold Mine Rd Ste 6
Pine Grove, CA 95665-9494
Mailing address
13828 Gold Mine Rd Ste 6
Pine Grove, CA 95665-9494
Phone (631) 838-0855
Other providers in Pine Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.