Provider Demographics
NPI:1306140132
Name:KAUR, AJINDER (DDS)
Entity type:Individual
Prefix:
First Name:AJINDER
Middle Name:
Last Name:KAUR
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 1:62 HASTINGS LN
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-3730
Mailing Address - Country:US
Mailing Address - Phone:857-234-9132
Mailing Address - Fax:
Practice Address - Street 1:387 QUARRY ST
Practice Address - Street 2:SUITE 100
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02723-1007
Practice Address - Country:US
Practice Address - Phone:508-679-8111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL10947122300000X, 1223G0001X
MADL11279122300000X
MADL11558122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice