Healthcare Provider Details

I. General information

NPI: 1073099594
Provider Name (Legal Business Name): JESSPREET SINGH PARMAR DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2018
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 W HIGHLAND DR
LAKELAND FL
33813-1543
US

IV. Provider business mailing address

320 W HIGHLAND DR
LAKELAND FL
33813-1543
US

V. Phone/Fax

Practice location:
  • Phone: 863-644-2428
  • Fax:
Mailing address:
  • Phone: 863-644-2428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDN21220
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: