Provider Demographics
NPI:1720519572
Name:TAK, PAVNEET SINGH (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAVNEET
Middle Name:SINGH
Last Name:TAK
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 1:15710 SPRING TRL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-3787
Mailing Address - Country:US
Mailing Address - Phone:832-273-3247
Mailing Address - Fax:
Practice Address - Street 1:15710 SPRING TRL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-3787
Practice Address - Country:US
Practice Address - Phone:832-273-3247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-23
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX38047122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program