Provider Demographics
NPI:1467758763
Name:SINGH, GURUSHARAN (DDS)
Entity Type:Individual
Prefix:
First Name:GURUSHARAN
Middle Name:
Last Name:SINGH
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 1:7007 US 31 S
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-8686
Mailing Address - Country:US
Mailing Address - Phone:317-535-7522
Mailing Address - Fax:317-535-5115
Practice Address - Street 1:7007 US 31 S
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-8686
Practice Address - Country:US
Practice Address - Phone:317-535-7522
Practice Address - Fax:317-535-5115
Is Sole Proprietor?:No
Enumeration Date:2011-02-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO103661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice