Provider Demographics
NPI:1619683414
Name:JASPREET RANDHAWA DMD, PLLC
Entity Type:Organization
Organization Name:JASPREET RANDHAWA DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASPREET
Authorized Official - Middle Name:
Authorized Official - Last Name:RANDHAWA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:214-923-4002
Mailing Address - Street 1:1645 N TOWN EAST BLVD
Mailing Address - Street 2:SUITE 532
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-4147
Mailing Address - Country:US
Mailing Address - Phone:972-681-5936
Mailing Address - Fax:972-681-5986
Practice Address - Street 1:1645 N TOWN EAST BLVD
Practice Address - Street 2:SUITE 532
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4147
Practice Address - Country:US
Practice Address - Phone:972-681-5936
Practice Address - Fax:972-681-5986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty