Healthcare Provider Details

I. General information

NPI: 1669235644
Provider Name (Legal Business Name): AMAN KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2024
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 SAINT JOHNS BLVD
JOPLIN MO
64804-1884
US

IV. Provider business mailing address

851 GREENHORN ST
BENTONVILLE AR
72712-3381
US

V. Phone/Fax

Practice location:
  • Phone: 417-208-0805
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number2025002150
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: