Healthcare Provider Details

I. General information

NPI: 1568210797
Provider Name (Legal Business Name): RUPINDER KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2024
Last Update Date: 04/19/2026
Certification Date: 04/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST SEATTLE WA 98195-6365
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

1959 NE PACIFIC ST SEATTLE WA 98195-6365
SEATTLE WA
98195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 206-543-0903
  • Fax:
Mailing address:
  • Phone: 206-543-0903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE61572667
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: