Healthcare Provider Details

I. General information

NPI: 1679411631
Provider Name (Legal Business Name): JASPINDER K SINGH SONOGRAPHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5775 GROVE PLACE XING SW
LILBURN GA
30047-8601
US

IV. Provider business mailing address

715 WINDEMERE OAK WAY NW
LILBURN GA
30047-8204
US

V. Phone/Fax

Practice location:
  • Phone: 404-519-2852
  • Fax:
Mailing address:
  • Phone: 404-519-2828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number168531
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: