Healthcare Provider Details

I. General information

NPI: 1760379028
Provider Name (Legal Business Name): JASMINE KAUR DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2025
Last Update Date: 02/22/2026
Certification Date: 02/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2517 JACKSON AVE
ANN ARBOR MI
48103-3818
US

IV. Provider business mailing address

2517 JACKSON AVE
ANN ARBOR MI
48103-3818
US

V. Phone/Fax

Practice location:
  • Phone: 734-882-2777
  • Fax:
Mailing address:
  • Phone: 734-882-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901602593
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: