Individual provider Active NPI

Manpreet Kaur, DMD

  • Dentist
  • Buckeye, AZ
National Provider Identifier
1205514809
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D012370 Issued in AZ
Practice address
946 S Watson Rd Ste 101
Buckeye, AZ 85326-3430
Phone
(623) 267-4676
NPI assigned
Jul 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X RR61435858 WA
Dentist 122300000X D012370 AZ Primary

Addresses

Primary practice location

946 S Watson Rd Ste 101
Buckeye, AZ 85326-3430

Mailing address

5302 Smitten St Unit 2
Yakima, WA 98908-2166
Phone (661) 340-4173

Other practice location 1

510 W 1st Ave
Toppenish, WA 98948-1564
Phone (509) 865-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D012370AZMDDentist
RR61435858WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Buckeye Modern Dentistry, LLP Dentist CurrentSince Feb 23, 2025 Accepting new patients

Locations

946 S Watson Rd
Ste 101
Buckeye, AZ 85326
Phone (623) 267-4676

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1205514809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5302 SMITTEN ST UNIT 2",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989082166",
            "telephone_number": "661-340-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "946 S WATSON RD STE 101",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853263430",
            "telephone_number": "623-267-4676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 W 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Toppenish",
            "state": "WA",
            "postal_code": "989481564",
            "country_code": "US",
            "telephone_number": "509-865-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUR",
        "first_name": "MANPREET",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "RR61435858",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D012370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckeye, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.