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General NPI Number Information
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NPI Number | 1457582892
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Entity Type | Individual
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Provider Name | KARANVIR SINGH SIBIA D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/03/2009
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Last Update Date | 11/05/2015
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Provider Practice Location Address
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Address Line | 3901 MADISON AVE # 5&10
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City | NORTH HIGHLANDS
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State | CA
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Zip | 95660-5095
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Country | US
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Telephone | 209-552-1813
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Fax |
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Provider Business Mailing Address
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Address Line | 1070 PLEASANT GROVE BLVD 110
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City | ROSEVILLE
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State | CA
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Zip | 95678-6124
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Country | US
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Telephone | 209-552-1813
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Fax | 916-772-0121
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 58529
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License Number State | CA
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