Active NPI
Simerjeet Kaur
- Dentist
- Riverdale, UT
National Provider Identifier
1629448170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 14288802-9926
- Practice address
- 4099 Riverdale Rd
Riverdale, UT 84405-1569 - Phone
- (385) 405-7044
- NPI assigned
- Sep 28, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 14288802-9926 | UT | Primary |
Addresses
Primary practice location
4099 Riverdale Rd
Riverdale, UT 84405-1569
Mailing address
4099 Riverdale Rd
Riverdale, UT 84405-1569
Phone (385) 405-7044
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151210000739 | WI | Order and Referring Only - Dentist | 6507167806 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1001211 | WI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Familia Dental Green Bay East LLC | Current | Accepting new patients | |
| Familia Dental Mkemitchell LLC | Past | Accepting new patients | |
| Mr. Teeth PLLC | Past | Accepting new patients |
Locations
2050 E Algonquin Rd
Ste 610
Schaumburg, IL 60173
Phone (847) 701-1457
1931 Main St
Green Bay, WI 54302
Phone (833) 225-0853
Organizations & group practices 3
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.
-
- Dental Clinic/Center
- Green Bay, WI
- NPI 1194188706
-
- General Practice Dentistry
- Riverdale, UT
- NPI 1619834868
-
- Dental Clinic/Center
- Milwaukee, WI
- NPI 1609259266
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782950400000",
"number": "1629448170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4099 RIVERDALE RD",
"city": "RIVERDALE",
"state": "UT",
"postal_code": "844051569",
"telephone_number": "385-405-7044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4099 RIVERDALE RD",
"city": "RIVERDALE",
"state": "UT",
"postal_code": "844051569",
"telephone_number": "385-405-7044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUR",
"first_name": "SIMERJEET",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-28",
"last_updated": "2026-07-02",
"certification_date": "2026-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "14288802-9926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Riverdale, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.