MEDICARE: DR. GURSHARANJIT SINGH DMD

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	30.028012	OH

General Provider Information

NPI Number	:	1669235412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GURSHARANJIT SINGH DMD

Provider Business Mailing Address
First Line	:	14184 SHELDON RD
Second Line	:
City	:	BROOKPARK
State	:	OH
Zip	:	44142-3863
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17117 DETROIT AVE
Second Line	:
City	:	LAKEWOOD
State	:	OH
Zip	:	44107-3622
Country	:	US
Telephone Number	:	216-221-0300
Fax Number	:

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

Provider Enumeration Date	:	02/05/2024
Last Update Date	:	06/09/2026

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