Healthcare Provider Details

I. General information

NPI: 1770325292
Provider Name (Legal Business Name): GURWINDER KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2024
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6099 N FIRST ST
FRESNO CA
93710
US

IV. Provider business mailing address

5343 S ORANGE AVE
FRESNO CA
93725-9575
US

V. Phone/Fax

Practice location:
  • Phone: 559-554-9791
  • Fax:
Mailing address:
  • Phone: 559-770-0931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number1770325292
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: