Provider Demographics
NPI:1922108505
Name:SINGH, RICKY (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICKY
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 1ST ST
Mailing Address - Street 2:APT# S-707
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105-2692
Mailing Address - Country:US
Mailing Address - Phone:267-738-3094
Mailing Address - Fax:
Practice Address - Street 1:914 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94707-2308
Practice Address - Country:US
Practice Address - Phone:510-524-6234
Practice Address - Fax:510-524-7608
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA500991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice