Provider Demographics
NPI:1285285569
Name:GURPREET KHAIRAH DDS PLLC
Entity type:Organization
Organization Name:GURPREET KHAIRAH DDS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GURPREET
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAIRAH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-609-1930
Mailing Address - Street 1:8460 S EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2864
Mailing Address - Country:US
Mailing Address - Phone:415-609-1930
Mailing Address - Fax:
Practice Address - Street 1:8460 S EASTERN AVE STE D
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2865
Practice Address - Country:US
Practice Address - Phone:702-270-0025
Practice Address - Fax:702-447-1717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental