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NPI Code Detail

MEDICARE: DR. RAJDEEP SINGH RANDHAWA D.D.S.

MEDICARE: DR. RAJDEEP SINGH RANDHAWA D.D.S.
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
11223G0001XGeneral Practice Dentistry22DI02201400NJ

General Provider Information

NPI Number : 1275748485
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAJDEEP SINGH RANDHAWA D.D.S.
Provider Business Mailing Address
First Line : 546 ST. GEORGES AVE
Second Line : SUITE 3
City : RAHWAY
State : NJ
Zip : 07065-2542
Country : US
Telephone Number : 732-882-1700
Fax Number : 732-882-1799
Provider Business Practice Location Address
First Line : 546 ST. GEORGES AVE
Second Line : SUITE 3
City : RAHWAY
State : NJ
Zip : 07065-2542
Country : US
Telephone Number : 732-882-1700
Fax Number : 732-882-1799
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2007
Last Update Date : 09/20/2007

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