MEDICARE: DR. SUNDEEP SINGH KHAHRA

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	6001283-15	WI

General Provider Information

NPI Number	:	1407565971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUNDEEP SINGH KHAHRA

Provider Business Mailing Address
First Line	:	10631 TURNBERRY DR
Second Line	:
City	:	MEQUON
State	:	WI
Zip	:	53092-6309
Country	:	US
Telephone Number	:	414-315-2302
Fax Number	:

Provider Business Practice Location Address
First Line	:	1432 W FOREST HOME AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53204-3228
Country	:	US
Telephone Number	:	414-277-8960
Fax Number	:

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

Provider Enumeration Date	:	11/23/2022
Last Update Date	:	04/28/2026

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