MEDICARE: PRABHJOT KAUR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	30.028285	OH

General Provider Information

NPI Number	:	1306703764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRABHJOT KAUR

Provider Business Mailing Address
First Line	:	6218 GLENWAY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-6314
Country	:	US
Telephone Number	:	513-245-8460
Fax Number	:

Provider Business Practice Location Address
First Line	:	6218 GLENWAY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-6314
Country	:	US
Telephone Number	:	513-245-8460
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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Directions to “ PRABHJOT KAUR ” Practice Location

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