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General NPI Number Information
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NPI Number | 1316204696
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Entity Type | Individual
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Provider Name | ISHERPREET SHERGILL MD,DDS
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Gender | Male
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Dates
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Enumeration Date | 04/11/2012
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 613 W HARWOOD RD
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City | HURST
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State | TX
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Zip | 76054-3161
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Country | US
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Telephone | 817-268-4108
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Fax |
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Provider Business Mailing Address
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Address Line | 344 COVE DR
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City | COPPELL
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State | TX
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Zip | 75019-5679
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Country | US
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Telephone | 312-451-9563
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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 | 38311
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | V8027
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License Number State | TX
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