MEDICARE: ROBINPREET SINGH PANNU DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	6171670	ID
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	12014033A	IN
3	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	S2-216	NV

General Provider Information

NPI Number	:	1063918746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBINPREET SINGH PANNU DDS

Provider Business Mailing Address
First Line	:	5958 SOLSTICE DR
Second Line	:
City	:	SPARKS
State	:	NV
Zip	:	89436-7141
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4451 N RANCHO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3405
Country	:	US
Telephone Number	:	702-723-9528
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2018
Last Update Date	:	02/16/2026

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