Provider Demographics
NPI:1336870823
Name:BAJWA, UMAIR (DDS)
Entity Type:Individual
Prefix:
First Name:UMAIR
Middle Name:
Last Name:BAJWA
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 1:1353 WESTHAMPTON WOODS CT
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-6324
Mailing Address - Country:US
Mailing Address - Phone:314-680-0303
Mailing Address - Fax:
Practice Address - Street 1:3536 RHOADS AVE
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-3702
Practice Address - Country:US
Practice Address - Phone:610-569-4296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.033841122300000X
IN12013853A122300000X
PADS044240122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist