Provider Demographics
NPI:1932832631
Name:SINGH, JOSHMAN RAJ (DDS)
Entity type:Individual
Prefix:
First Name:JOSHMAN
Middle Name:RAJ
Last Name:SINGH
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 1:2652 SABERCAT CT
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-5647
Mailing Address - Country:US
Mailing Address - Phone:510-674-3840
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:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-08
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0438041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice