Healthcare Provider Details

I. General information

NPI: 1497649834
Provider Name (Legal Business Name): JASJOT KAUR DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4491 FAR HILLS AVE
KETTERING OH
45429-2405
US

IV. Provider business mailing address

903 AINTREE PARK DR APT 102
MAYFIELD VILLAGE OH
44143-3554
US

V. Phone/Fax

Practice location:
  • Phone: 937-298-1353
  • Fax:
Mailing address:
  • Phone: 216-317-9870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.027998
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: