Provider Demographics
NPI:1932411246
Name:KAMBOJ, RATTANJIT SINGH (DMD)
Entity Type:Individual
Prefix:DR
First Name:RATTANJIT
Middle Name:SINGH
Last Name:KAMBOJ
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 1:169 DEEPDALE PKWY
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-1223
Mailing Address - Country:US
Mailing Address - Phone:516-902-9621
Mailing Address - Fax:
Practice Address - Street 1:169 DEEPDALE PKWY
Practice Address - Street 2:
Practice Address - City:ALBERTSON
Practice Address - State:NY
Practice Address - Zip Code:11507-1223
Practice Address - Country:US
Practice Address - Phone:516-902-9621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY055510122300000X
PADS039734122300000X
NJ22DI02554400122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program