Provider Demographics
NPI:1821542366
Name:BAINS, PAVNEET (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAVNEET
Middle Name:
Last Name:BAINS
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 1:190 RYLAND ST APT 3227
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95110-3905
Mailing Address - Country:US
Mailing Address - Phone:916-799-2794
Mailing Address - Fax:
Practice Address - Street 1:1680 WESTWOOD DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-5105
Practice Address - Country:US
Practice Address - Phone:408-266-0388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-13
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1087921223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics