Healthcare Provider Details

I. General information

NPI: 1902293897
Provider Name (Legal Business Name): HARLEEN KAUR DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2015
Last Update Date: 05/19/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 INDIAN RD STE 7
DENVILLE NJ
07834-2000
US

IV. Provider business mailing address

1 INDIAN RD STE 7
DENVILLE NJ
07834-2000
US

V. Phone/Fax

Practice location:
  • Phone: 973-625-4220
  • Fax:
Mailing address:
  • Phone: 973-625-4220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS040497
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number22D1O2748300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: