Provider Demographics
NPI:1427888676
Name:SINGH DENTAL GROUP LLC
Entity type:Organization
Organization Name:SINGH DENTAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHMAN
Authorized Official - Middle Name:RAJ
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-674-3840
Mailing Address - Street 1:4100 PORTOLA DR STE 2
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-4500
Mailing Address - Country:US
Mailing Address - Phone:831-475-4100
Mailing Address - Fax:
Practice Address - Street 1:4100 PORTOLA DR STE 2
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-4500
Practice Address - Country:US
Practice Address - Phone:831-475-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental