Provider Demographics
NPI:1467131722
Name:DHILLON, CHARANBIR SINGH (DDS)
Entity type:Individual
Prefix:
First Name:CHARANBIR
Middle Name:SINGH
Last Name:DHILLON
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ADRIAN CT APT 2421
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-2123
Mailing Address - Country:US
Mailing Address - Phone:714-829-0718
Mailing Address - Fax:
Practice Address - Street 1:1130 FOLSOM ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-3928
Practice Address - Country:US
Practice Address - Phone:415-552-7874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-14
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CADDS111268122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program