Provider Demographics
NPI:1104033604
Name:RADIA, HARVEEN SINGH (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:HARVEEN
Middle Name:SINGH
Last Name:RADIA
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:HARVEEN
Other - Middle Name:
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:417 10TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90402-2031
Mailing Address - Country:US
Mailing Address - Phone:310-600-0404
Mailing Address - Fax:
Practice Address - Street 1:1964 WESTWOOD BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-8424
Practice Address - Country:US
Practice Address - Phone:310-446-4867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA503741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1223G0001XDental ProvidersDentistGeneral Practice