Healthcare Provider Details

I. General information

NPI: 1720974355
Provider Name (Legal Business Name): SURDEEP DENTAL GROUP OF FRESNO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1064 LEWIS ST
KINGSBURG CA
93631-2414
US

IV. Provider business mailing address

1064 LEWIS ST
KINGSBURG CA
93631-2414
US

V. Phone/Fax

Practice location:
  • Phone: 559-897-2600
  • Fax:
Mailing address:
  • Phone: 559-897-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. SURDEEP SINGH
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 559-708-9099