Healthcare Provider Details

I. General information

NPI: 1821934282
Provider Name (Legal Business Name): KAUR SMILES DENTAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 W BULLARD AVE STE 119
CLOVIS CA
93612-0861
US

IV. Provider business mailing address

PO BOX 2098
CLOVIS CA
93613-2098
US

V. Phone/Fax

Practice location:
  • Phone: 559-753-6949
  • Fax: 559-753-6949
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: RAJDEEP KAUR
Title or Position: OWNER
Credential: DDS
Phone: 559-753-6949