Healthcare Provider Details

I. General information

NPI: 1740417377
Provider Name (Legal Business Name): JASMEET KAUR D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2009
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 MADISON AVE
BRIDGEPORT CT
06606-3239
US

IV. Provider business mailing address

2240 MADISON AVE
BRIDGEPORT CT
06606-3239
US

V. Phone/Fax

Practice location:
  • Phone: 203-372-0881
  • Fax:
Mailing address:
  • Phone: 203-372-0881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number10429
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1855178
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN1855178
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number010429
License Number StateCT
# 5
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number010429
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: