Healthcare Provider Details

I. General information

NPI: 1568397297
Provider Name (Legal Business Name): KANWALPREET KAUR DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3904 HULL STREET RD STE A
RICHMOND VA
23224-1714
US

IV. Provider business mailing address

12216 MARSETT CT UNIT 101
GLEN ALLEN VA
23059-6060
US

V. Phone/Fax

Practice location:
  • Phone: 312-274-4529
  • Fax:
Mailing address:
  • Phone: 804-461-7014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401420104
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: