Provider Demographics
NPI:1194985895
Name:SINGH, SHAILAJA (DDS)
Entity type:Individual
Prefix:DR
First Name:SHAILAJA
Middle Name:
Last Name:SINGH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 W GRANT LINE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-2599
Mailing Address - Country:US
Mailing Address - Phone:209-833-0020
Mailing Address - Fax:
Practice Address - Street 1:385 W GRANT LINE RD STE 101
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-2599
Practice Address - Country:US
Practice Address - Phone:209-833-0020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50989122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist