Provider Demographics
NPI:1396222352
Name:MANN, ROOPINDER SINGH (DMD)
Entity Type:Individual
Prefix:
First Name:ROOPINDER
Middle Name:SINGH
Last Name:MANN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7628 N VIA DE MANANA
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-3517
Mailing Address - Country:US
Mailing Address - Phone:510-378-0841
Mailing Address - Fax:
Practice Address - Street 1:1630 S PACIFIC AVE STE 104
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-2111
Practice Address - Country:US
Practice Address - Phone:928-783-0804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0101311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice