Provider Demographics
NPI:1992109524
Name:SINGH, AJAYBIR (DMD)
Entity type:Individual
Prefix:
First Name:AJAYBIR
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5808 BAY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-5210
Mailing Address - Country:US
Mailing Address - Phone:240-705-1788
Mailing Address - Fax:
Practice Address - Street 1:1880 W MOORE AVE STE 7
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-2365
Practice Address - Country:US
Practice Address - Phone:972-563-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-10
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1856791122300000X
CT11302122300000X, 1223G0001X
TX33403122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice