MEDICARE: JINDIA DDS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1184205171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JINDIA DDS INC

Provider Business Mailing Address
First Line	:	233 W BADILLO ST STE B
Second Line	:
City	:	COVINA
State	:	CA
Zip	:	91723-1966
Country	:	US
Telephone Number	:	860-268-2040
Fax Number	:

Provider Business Practice Location Address
First Line	:	5727 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-4712
Country	:	US
Telephone Number	:	562-423-8385
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. RAJAT JINDIA
Credential	:	DDS
Telephone Number	:	860-268-2040

Provider Enumeration Date	:	04/20/2021
Last Update Date	:	04/20/2021

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