Provider Demographics
NPI:1417518168
Name:SINGHAL, SMITA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SMITA
Middle Name:
Last Name:SINGHAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1346 W WYOMISSING CT APT K
Mailing Address - Street 2:
Mailing Address - City:WEST LAWN
Mailing Address - State:PA
Mailing Address - Zip Code:19609-2348
Mailing Address - Country:US
Mailing Address - Phone:315-708-8318
Mailing Address - Fax:
Practice Address - Street 1:1032 PARK RD
Practice Address - Street 2:
Practice Address - City:BLANDON
Practice Address - State:PA
Practice Address - Zip Code:19510-9558
Practice Address - Country:US
Practice Address - Phone:610-926-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS042235122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty