Provider Demographics
NPI:1770719031
Name:SINGH, JAGJEET (DMD)
Entity type:Individual
Prefix:
First Name:JAGJEET
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 1:1634 BLUE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02126-2121
Mailing Address - Country:US
Mailing Address - Phone:617-298-2000
Mailing Address - Fax:617-298-2002
Practice Address - Street 1:1634 BLUE HILL AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02126-2121
Practice Address - Country:US
Practice Address - Phone:617-298-2000
Practice Address - Fax:617-298-2002
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1855130122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist