Provider Demographics
NPI:1770563322
Name:VASDEV, PARABHAJOT (DMD)
Entity type:Individual
Prefix:DR
First Name:PARABHAJOT
Middle Name:
Last Name:VASDEV
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 1:1812 2ND ST SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-4127
Mailing Address - Country:US
Mailing Address - Phone:507-208-4141
Mailing Address - Fax:507-204-4140
Practice Address - Street 1:1812 2ND ST SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-4127
Practice Address - Country:US
Practice Address - Phone:507-208-4141
Practice Address - Fax:507-204-4140
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2008-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND11094122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN592023000Medicaid
MN592023000Medicare ID - Type Unspecified