Provider Demographics
NPI:1346591666
Name:JUDGE, NAVPREET (DDS)
Entity Type:Individual
Prefix:DR
First Name:NAVPREET
Middle Name:
Last Name:JUDGE
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 1:1105 N LAFAYETTE DRIVE
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150
Mailing Address - Country:US
Mailing Address - Phone:803-774-3600
Mailing Address - Fax:803-774-4560
Practice Address - Street 1:1105 N LAFAYETTE DRIVE
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150
Practice Address - Country:US
Practice Address - Phone:803-774-3600
Practice Address - Fax:803-774-4560
Is Sole Proprietor?:No
Enumeration Date:2012-09-26
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX281941223G0001X
SC101511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX311299703Medicaid