Provider Demographics
NPI:1659928034
Name:NIJJAR, SAHAJ SINGH (DDS)
Entity Type:Individual
Prefix:
First Name:SAHAJ
Middle Name:SINGH
Last Name:NIJJAR
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 1:5896 MOUNTAIN HAWK DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95409-4356
Mailing Address - Country:US
Mailing Address - Phone:707-228-6942
Mailing Address - Fax:
Practice Address - Street 1:2790 NE 106TH AVE STE A
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-7449
Practice Address - Country:US
Practice Address - Phone:503-844-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD112271223G0001X
CA1042941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice