Healthcare Provider Details

I. General information

NPI: 1225292121
Provider Name (Legal Business Name): HARJIT SINGH SEHGAL BDS,MS,DIPLOMATE-ABP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 05/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 SW MOODEY AVE CLSB-5N034
PORTLAND OR
97201
US

IV. Provider business mailing address

2730 SW MOODEY AVE CLSB-5N034
PORTLAND OR
97201
US

V. Phone/Fax

Practice location:
  • Phone: 503-494-8949
  • Fax:
Mailing address:
  • Phone: 503-494-8949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDF0028
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberS66
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: