Provider Demographics
NPI:1154914737
Name:NARULA, JAI SINGH (DDS)
Entity type:Individual
Prefix:
First Name:JAI
Middle Name:SINGH
Last Name:NARULA
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 1:70679 BOOTHILL RD
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3405
Mailing Address - Country:US
Mailing Address - Phone:760-567-5101
Mailing Address - Fax:
Practice Address - Street 1:44853 PORTOLA AVE STE B
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-3703
Practice Address - Country:US
Practice Address - Phone:760-851-0643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106006122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist