Healthcare Provider Details

I. General information

NPI: 1205765740
Provider Name (Legal Business Name): AKASHPREET KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6467 N RIVERSIDE DR STE 107
FRESNO CA
93722-9329
US

IV. Provider business mailing address

828 S LAVERNE AVE
FRESNO CA
93727-5690
US

V. Phone/Fax

Practice location:
  • Phone: 559-728-8011
  • Fax:
Mailing address:
  • Phone: 559-728-8011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number112927
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: