Provider Demographics
NPI:1285248682
Name:KHERA, GAGANJOT KAUR (DDS)
Entity type:Individual
Prefix:
First Name:GAGANJOT
Middle Name:KAUR
Last Name:KHERA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:292 APPIAN WAY
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-3706
Mailing Address - Country:US
Mailing Address - Phone:510-953-1276
Mailing Address - Fax:
Practice Address - Street 1:1070 N DAVIS RD STE D
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93907-2045
Practice Address - Country:US
Practice Address - Phone:831-757-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-02
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105431122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist