MEDICARE: AJIPAL SINGH SEKHON DDS INC.

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	261QD0000X	Dental Clinic/Center	DDS57757	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1366693939	OTHER	CA	NPI

General Provider Information

NPI Number	:	1588177059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AJIPAL SINGH SEKHON DDS INC.

Provider Business Mailing Address
First Line	:	540 BOGUE RD STE W6
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95991-9245
Country	:	US
Telephone Number	:	530-822-9090
Fax Number	:	530-822-9096

Provider Business Practice Location Address
First Line	:	540 BOGUE RD STE W6
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95991-9245
Country	:	US
Telephone Number	:	530-822-9090
Fax Number	:	530-822-9096

Authorized Official
Title or Position	:	OWNER DOCTOR
Name	:	DR. AJIPAL SINGH SEKHON
Credential	:	DDS
Telephone Number	:	530-822-9090

Provider Enumeration Date	:	11/07/2017
Last Update Date	:	11/07/2017

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