Gurpreet Kaur

Primary specialty

DentistTaxonomy code 122300000X

License

DE61068950 Issued in WA

Practice address

626 2ND Ave S
Okanogan, WA 98840

Phone

(509) 422-6705

NPI assigned

Mar 27, 2019

Last updated

Mar 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1891256350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 LYONS PL NE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980595193",
            "telephone_number": "425-894-6768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 2ND AVE S",
            "city": "OKANOGAN",
            "state": "WA",
            "postal_code": "98840",
            "telephone_number": "509-422-6705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4915 25th Ave NE Ste 215",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981055667",
            "country_code": "US",
            "telephone_number": "206-524-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUR",
        "first_name": "GURPREET",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61068950",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theodore Graham, D.D.S.
• Denny Willis Homer, DMD
• Roy Huffstetler, PA-C
• J and S Drug
• Ryann Joy Joyner, LMT
• Jordan Kehne
• Rebecca Kelly-Malone, OTR-L
• Rita Kessell, LMP
• Jenell Lynn Kruse, LMP
• Wayne David Lawson, D.C.

• Dentist in Okanogan, WA
• Providers in Okanogan, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.

Verify at the official NPI Registry.