Healthcare Provider Details

I. General information

NPI: 1336715077
Provider Name (Legal Business Name): HARSIMRAN KAUR DDS DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2021
Last Update Date: 08/06/2021
Certification Date: 08/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4605 BUENA VISTA RD STE 660
BAKERSFIELD CA
93311-8793
US

IV. Provider business mailing address

4605 BUENA VISTA RD STE 660
BAKERSFIELD CA
93311-8793
US

V. Phone/Fax

Practice location:
  • Phone: 661-454-7600
  • Fax: 661-454-7601
Mailing address:
  • Phone: 661-454-7600
  • Fax: 661-454-7601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. HARSIMRAN KAUR
Title or Position: OWNER
Credential: DMD
Phone: 213-793-1618