Provider Demographics
NPI:1164785952
Name:SINGH, RAVISHER (DMD, MDS)
Entity Type:Individual
Prefix:DR
First Name:RAVISHER
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:DMD, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10710 RESEARCH BLVD
Mailing Address - Street 2:STE 302
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5798
Mailing Address - Country:US
Mailing Address - Phone:301-906-6614
Mailing Address - Fax:
Practice Address - Street 1:10710 RESEARCH BLVD
Practice Address - Street 2:STE 302
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5798
Practice Address - Country:US
Practice Address - Phone:512-568-3560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15076122300000X
TX298741223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist