Provider Demographics
NPI:1427223486
Name:JAGINI, SANDEEP (DMD)
Entity type:Individual
Prefix:
First Name:SANDEEP
Middle Name:
Last Name:JAGINI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-3537
Mailing Address - Country:US
Mailing Address - Phone:203-795-4748
Mailing Address - Fax:
Practice Address - Street 1:297 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3537
Practice Address - Country:US
Practice Address - Phone:203-795-4748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI029656001223G0001X
MADN215751223G0001X
CT0105051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice