Healthcare Provider Details

I. General information

NPI: 1073472767
Provider Name (Legal Business Name): BISHAKHA SINGH DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 PROGRESS RD
HANNIBAL MO
63401-6637
US

IV. Provider business mailing address

PO BOX 844715
KANSAS CITY MO
64184-4715
US

V. Phone/Fax

Practice location:
  • Phone: 573-603-1460
  • Fax:
Mailing address:
  • Phone: 417-761-5214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2026045957
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: