Healthcare Provider Details

I. General information

NPI: 1487577169
Provider Name (Legal Business Name): SHARANPREET KAUR KOONER DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 S GREEN RIVER RD STE A
EVANSVILLE IN
47715-4106
US

IV. Provider business mailing address

3351 WHITE OAK TRL
NEWBURGH IN
47630-9443
US

V. Phone/Fax

Practice location:
  • Phone: 812-324-1981
  • Fax:
Mailing address:
  • Phone: 530-300-8281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number12015107A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: