Provider Demographics
NPI:1699095505
Name:RATTAN, TEJDEEP SINGH (DDS)
Entity type:Individual
Prefix:
First Name:TEJDEEP
Middle Name:SINGH
Last Name:RATTAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 W LAS BRISAS DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOUSE
Mailing Address - State:CA
Mailing Address - Zip Code:95391
Mailing Address - Country:US
Mailing Address - Phone:937-369-7843
Mailing Address - Fax:
Practice Address - Street 1:477 W LAS BRISAS DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOUSE
Practice Address - State:CA
Practice Address - Zip Code:95391-2082
Practice Address - Country:US
Practice Address - Phone:937-369-7843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010239122300000X
CA64387122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist