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General NPI Number Information
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NPI Number | 1093592107
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Entity Type | Individual
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Provider Name | JOGDEEP SINGH JAGPAL DDS
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Gender | Male
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Dates
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Enumeration Date | 09/12/2023
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 4022 SUNRISE BLVD STE 160
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City | RANCHO CORDOVA
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State | CA
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Zip | 95742-6908
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Country | US
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Telephone | 916-246-1108
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Fax |
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Provider Business Mailing Address
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Address Line | 324 ANCHORAGE DR
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City | VACAVILLE
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State | CA
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Zip | 95687-7896
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Country | US
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Telephone | 916-743-0137
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 109366
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License Number State | CA
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