Provider Demographics
NPI:1598251878
Name:SANJEET RAJ SINGH PARMAR DDS LTD
Entity Type:Organization
Organization Name:SANJEET RAJ SINGH PARMAR DDS LTD
Other - Org Name:DIVISION DENTAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANJEET
Authorized Official - Middle Name:RAJ SINGH
Authorized Official - Last Name:PARMAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-235-0980
Mailing Address - Street 1:2632 W DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-2850
Mailing Address - Country:US
Mailing Address - Phone:773-235-0980
Mailing Address - Fax:773-235-1249
Practice Address - Street 1:2632 W DIVISION ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-2850
Practice Address - Country:US
Practice Address - Phone:773-235-0980
Practice Address - Fax:773-235-1249
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SANJEET RAJ SINGH PARMAR DDS LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL019027696Medicaid