Healthcare Provider Details

I. General information

NPI: 1144023805
Provider Name (Legal Business Name): LOVEJIT KAUR DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2025
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 MACDADE BLVD STE G
DARBY PA
19023-1814
US

IV. Provider business mailing address

350 N CLARK ST STE 600
CHICAGO IL
60654-4782
US

V. Phone/Fax

Practice location:
  • Phone: 312-274-4520
  • Fax:
Mailing address:
  • Phone: 312-274-4520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS045179
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: