Provider Demographics
NPI:1629385943
Name:CHHABRA, DALJIT (DMD)
Entity Type:Individual
Prefix:DR
First Name:DALJIT
Middle Name:
Last Name:CHHABRA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6541 CROWN BLVD
Mailing Address - Street 2:#G
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95120-2907
Mailing Address - Country:US
Mailing Address - Phone:408-268-4161
Mailing Address - Fax:408-268-5745
Practice Address - Street 1:6541 CROWN BLVD
Practice Address - Street 2:#G
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95120-2907
Practice Address - Country:US
Practice Address - Phone:408-268-4161
Practice Address - Fax:408-268-5745
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA490781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice