Individual provider Active NPI

Amandeep Kaur

  • General Practice Dentistry
  • Fresno, CA
National Provider Identifier
1417668526
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
108407 Issued in CA
Practice address
4668 W Amherst Ave
Fresno, CA 93722-8020
Phone
(559) 892-7304
NPI assigned
Dec 9, 2022
Last updated
Dec 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 108407 CA Primary

Addresses

Primary practice location

4668 W Amherst Ave
Fresno, CA 93722-8020

Mailing address

4668 W Amherst Ave
Fresno, CA 93722-8020
Phone (559) 892-7304

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
108407CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1417668526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4668 W AMHERST AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937228020",
            "telephone_number": "559-892-7304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4668 W AMHERST AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937228020",
            "telephone_number": "559-892-7304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUR",
        "first_name": "AMANDEEP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "108407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.