Provider Demographics
NPI:1134280563
Name:SINGH, JASMEEN KAUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JASMEEN
Middle Name:KAUR
Last Name:SINGH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JASMEEN
Other - Middle Name:
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:18014 WOLF RD
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-5407
Mailing Address - Country:US
Mailing Address - Phone:708-326-1175
Mailing Address - Fax:708-326-1179
Practice Address - Street 1:18014 WOLF RD
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-5407
Practice Address - Country:US
Practice Address - Phone:708-326-1175
Practice Address - Fax:708-326-1179
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019026844122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9184058Medicaid