Provider Demographics
NPI:1154453553
Name:SINGH, JUPNEESH (DDS)
Entity type:Individual
Prefix:DR
First Name:JUPNEESH
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4215 W DUNLAP AVE
Mailing Address - Street 2:SUITE# 3
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-3684
Mailing Address - Country:US
Mailing Address - Phone:623-934-6400
Mailing Address - Fax:623-934-6406
Practice Address - Street 1:4215 W DUNLAP AVE
Practice Address - Street 2:SUITE# 3
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-3684
Practice Address - Country:US
Practice Address - Phone:623-934-6400
Practice Address - Fax:623-934-6406
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6360122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist