Provider Demographics
NPI:1063391522
Name:SINGH, SANDEEP
Entity type:Individual
Prefix:
First Name:SANDEEP
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5475 BECKLEY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-4146
Mailing Address - Country:US
Mailing Address - Phone:269-979-7710
Mailing Address - Fax:
Practice Address - Street 1:5475 BECKLEY RD STE 100
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4146
Practice Address - Country:US
Practice Address - Phone:269-979-7710
Practice Address - Fax:269-979-7798
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016027631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice