Provider Demographics
NPI:1669143806
Name:DARAR, HARDEEP K
Entity type:Individual
Prefix:
First Name:HARDEEP
Middle Name:K
Last Name:DARAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 PIERCE ST NE UNIT 854
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-2097
Mailing Address - Country:US
Mailing Address - Phone:260-494-2950
Mailing Address - Fax:
Practice Address - Street 1:1166 STATE ROUTE 3 S STE 211
Practice Address - Street 2:
Practice Address - City:GAMBRILLS
Practice Address - State:MD
Practice Address - Zip Code:21054-1776
Practice Address - Country:US
Practice Address - Phone:260-494-2950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17555122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist