Provider Demographics
NPI:1346962271
Name:SURDEEP SINGH DDS INC
Entity Type:Organization
Organization Name:SURDEEP SINGH DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SURDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:559-708-9099
Mailing Address - Street 1:1795 HERNDON AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-6199
Mailing Address - Country:US
Mailing Address - Phone:559-840-4330
Mailing Address - Fax:
Practice Address - Street 1:1795 HERNDON AVE STE 104
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6199
Practice Address - Country:US
Practice Address - Phone:559-840-4330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA105838OtherDENTIST