Individual provider Active NPI

Gurpreet Kaur, DENTIST

  • Dentist
  • Detroit, MI
National Provider Identifier
1104495316
Registry record updated Jun 22, 2021
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901600970 Issued in MI
Practice address
20720 Plymouth Rd
Detroit, MI 48228-1275
Phone
(313) 342-1997
NPI assigned
Jun 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 2901600970 MI Primary

Addresses

Primary practice location

20720 Plymouth Rd
Detroit, MI 48228-1275

Mailing address

2013 Medford Rd Apt 261
Ann Arbor, MI 48104-4951
Phone (214) 971-6882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210803002937 MI Order and Referring Only - DentistPractitioner - Dentist 6608270368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1104495316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 MEDFORD RD APT 261",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044951",
            "telephone_number": "214-971-6882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20720 PLYMOUTH RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482281275",
            "telephone_number": "313-342-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUR",
        "first_name": "GURPREET",
        "name_prefix": "Dr.",
        "credential": "DENTIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901600970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.