Healthcare Provider Details

I. General information

NPI: 1134065816
Provider Name (Legal Business Name): AEKUM SINGH GREWAL DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 ELMWOOD AVE
ROCHESTER NY
14620-2913
US

IV. Provider business mailing address

1324 LOCUST ST APT 604
PHILADELPHIA PA
19107-5646
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-5051
  • Fax:
Mailing address:
  • Phone: 609-922-6452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: