Provider Demographics
NPI:1124471040
Name:GHUMAN, JASPREET SINGH
Entity type:Individual
Prefix:
First Name:JASPREET SINGH
Middle Name:
Last Name:GHUMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JASPREET
Other - Middle Name:
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5227 W ADAMS AVE
Mailing Address - Street 2:APT 608
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-4851
Mailing Address - Country:US
Mailing Address - Phone:213-793-6836
Mailing Address - Fax:
Practice Address - Street 1:2402 S 61ST ST
Practice Address - Street 2:APT 210 B
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-8011
Practice Address - Country:US
Practice Address - Phone:213-793-6836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32001122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist