MEDICARE: DR. SIMARJIT SINGH 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
1	122300000X	Dentist	50532	CA

General Provider Information

NPI Number	:	1609114669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIMARJIT SINGH D.D.S.

Provider Business Mailing Address
First Line	:	2140 SHATTUCK AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94704-1210
Country	:	US
Telephone Number	:	510-843-1192
Fax Number	:

Provider Business Practice Location Address
First Line	:	2140 SHATTUCK AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94704-1210
Country	:	US
Telephone Number	:	510-843-1192
Fax Number	:

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

Provider Enumeration Date	:	01/26/2013
Last Update Date	:	01/26/2013

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