Individual provider Active NPI

Ishpreet Kaur

  • Dentist
  • Mesa, AZ
National Provider Identifier
1518573237
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D012036 Issued in AZ
Practice address
1310 E McKellips Rd Ste 105
Mesa, AZ 85203-2722
Phone
(480) 697-6393
NPI assigned
Sep 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D11340 OR
Dentist 122300000X D012036 AZ Primary

Addresses

Primary practice location

1310 E McKellips Rd Ste 105
Mesa, AZ 85203-2722

Mailing address

817 W Glenmere Dr
Chandler, AZ 85225-6969
Phone (480) 748-8696

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
D012036AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dentists of North Mesa, LLP CurrentSince Feb 4, 2024 Accepting new patients

Locations

1310 E McKellips Rd
Ste 105
Mesa, AZ 85203
Phone (480) 697-6393

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": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1518573237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 W GLENMERE DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852256969",
            "telephone_number": "480-748-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 E MCKELLIPS RD STE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852032722",
            "telephone_number": "480-697-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUR",
        "first_name": "ISHPREET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-17",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11340",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D012036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.