Provider Demographics
NPI:1275748485
Name:RANDHAWA, RAJDEEP SINGH (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAJDEEP
Middle Name:SINGH
Last Name:RANDHAWA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 ST. GEORGES AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-2542
Mailing Address - Country:US
Mailing Address - Phone:732-882-1700
Mailing Address - Fax:732-882-1799
Practice Address - Street 1:546 ST. GEORGES AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2542
Practice Address - Country:US
Practice Address - Phone:732-882-1700
Practice Address - Fax:732-882-1799
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022014001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice