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General NPI Number Information
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NPI Number | 1679899348
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Entity Type | Individual
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Provider Name | JIVTESH SINGH D.D.S
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Gender | Male
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Dates
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Enumeration Date | 04/20/2010
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Last Update Date | 04/20/2010
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Provider Practice Location Address
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Address Line | 1644 DEER PARK AVE
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City | DEER PARK
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State | NY
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Zip | 11729-5211
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Country | US
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Telephone | 631-586-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 38 RIM LN
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City | HICKSVILLE
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State | NY
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Zip | 11801-6117
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Country | US
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Telephone | 917-913-0606
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 054842-1
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License Number State | NY
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