Provider Demographics
NPI:1760550685
Name:UPPAL, CHARANJIT SINGH (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARANJIT
Middle Name:SINGH
Last Name:UPPAL
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 1:1191 W TENNYSON RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-4454
Mailing Address - Country:US
Mailing Address - Phone:510-786-1780
Mailing Address - Fax:510-786-1351
Practice Address - Street 1:1191 W TENNYSON RD
Practice Address - Street 2:SUITE 4
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-4454
Practice Address - Country:US
Practice Address - Phone:510-786-1780
Practice Address - Fax:510-786-1351
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45048122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB45048-01OtherDENTI-CAL