Provider Demographics
NPI:1659865624
Name:SINGH, JATINDER (DDS)
Entity Type:Individual
Prefix:DR
First Name:JATINDER
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 1:25805 83RD AVE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1606
Mailing Address - Country:US
Mailing Address - Phone:516-395-5376
Mailing Address - Fax:
Practice Address - Street 1:4400 N MIDKIFF RD STE A-1
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-4219
Practice Address - Country:US
Practice Address - Phone:432-789-1021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX342841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice