Provider Demographics
NPI:1407588593
Name:JASVINDER BADWALZ DMD PLLC
Entity Type:Organization
Organization Name:JASVINDER BADWALZ DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JASVINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:BADWALZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-747-8534
Mailing Address - Street 1:1421 N LEE TREVINO DR STE D10
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6434
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1421 N LEE TREVINO DR STE D10
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6434
Practice Address - Country:US
Practice Address - Phone:915-593-1328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JASVINDER BADWALZ DMD PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty