Provider Demographics
NPI:1528503141
Name:AJAIPAL SINGH SEKHON, DDS, PLLC
Entity type:Organization
Organization Name:AJAIPAL SINGH SEKHON, DDS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:AJAIPAL
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:SEKHON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:530-218-6299
Mailing Address - Street 1:5101 N PEARL ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:RUSTON
Mailing Address - State:WA
Mailing Address - Zip Code:98407-3212
Mailing Address - Country:US
Mailing Address - Phone:253-302-3980
Mailing Address - Fax:
Practice Address - Street 1:2716 N 31ST ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98407-6405
Practice Address - Country:US
Practice Address - Phone:530-218-6299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE603893351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty