Provider Demographics
NPI:1619740214
Name:PARAGON DENTAL MANAGEMENT LLC
Entity Type:Organization
Organization Name:PARAGON DENTAL MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MEENAKSHI
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-905-6477
Mailing Address - Street 1:2355 SAN RAMON VALLEY BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1597
Mailing Address - Country:US
Mailing Address - Phone:925-905-6477
Mailing Address - Fax:
Practice Address - Street 1:2355 SAN RAMON VALLEY BLVD STE 104
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1597
Practice Address - Country:US
Practice Address - Phone:925-905-6477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-06
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty