Individual provider Active NPI

Gurveen Kaur Khatkar, DDS

  • Dentist
  • Graham, WA
National Provider Identifier
1740897545
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE61088084 Issued in WA
Practice address
22205 Meridian E Ste 109
Graham, WA 98338-9781
Phone
(253) 875-6599
NPI assigned
Sep 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D11345 OR
Dentist 122300000X DE61088084 WA Primary

Addresses

Primary practice location

22205 Meridian E Ste 109
Graham, WA 98338-9781

Mailing address

22205 Meridian E Ste 109
Graham, WA 98338-9781
Phone (253) 875-6599

Other practice location 1

2725 S 6th St
Klamath Falls, OR 97603-4603
Phone (541) 887-3046

Other practice location 2

9125 Bridgeport Way SW Ste 101
Lakewood, WA 98499-2448
Phone (253) 581-6140

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
D11345ORMDDentist
DE61088084WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Seung Jae Joung DMD PLLC CurrentSince Oct 1, 2023 Accepting new patients
Drew Dentistry CurrentSince Dec 1, 2022 Accepting new patients
Jun Carrington DMD PLLC PastSince Dec 1, 2022 Accepting new patients
DJ and Ak Spencer DMD PS Dentist PastSince Oct 1, 2023 Accepting new patients

Locations

22205 Meridian E
Ste 109
Graham, WA 98338
Phone (253) 875-6599

9125 Bridgeport Way SW
Ste 101
Lakewood, WA 98499
Phone (253) 581-6140

Organizations & group practices 4

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": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1740897545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22205 MERIDIAN E STE 109",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "983389781",
            "telephone_number": "253-875-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22205 MERIDIAN E STE 109",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "983389781",
            "telephone_number": "253-875-6599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2725 S 6th St",
            "address_purpose": "LOCATION",
            "city": "Klamath Falls",
            "state": "OR",
            "postal_code": "976034603",
            "country_code": "US",
            "telephone_number": "541-887-3046",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9125 Bridgeport Way SW Ste 101",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "WA",
            "postal_code": "984992448",
            "country_code": "US",
            "telephone_number": "253-581-6140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHATKAR",
        "first_name": "GURVEEN",
        "middle_name": "KAUR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-25",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11345",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61088084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Graham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.