Provider Demographics
NPI:1740802677
Name:VIRDI, INDERPAL SINGH (DDS)
Entity Type:Individual
Prefix:DR
First Name:INDERPAL
Middle Name:SINGH
Last Name:VIRDI
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 1:22 SINGER CT
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-1183
Mailing Address - Country:US
Mailing Address - Phone:732-675-0324
Mailing Address - Fax:
Practice Address - Street 1:335 PRINCETON HIGHTSTOWN RD UNIT 25
Practice Address - Street 2:
Practice Address - City:WEST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08550-3121
Practice Address - Country:US
Practice Address - Phone:609-779-2054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-14
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ22DI028144001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program