MEDICARE: JASVINDER BADWALZ DMD PLLC

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1992493811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JASVINDER BADWALZ DMD PLLC

Provider Business Mailing Address
First Line	:	5939 GATEWAY BLVD W
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79925-3323
Country	:	US
Telephone Number	:	915-779-5781
Fax Number	:

Provider Business Practice Location Address
First Line	:	5939 GATEWAY BLVD W
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79925-3323
Country	:	US
Telephone Number	:	915-779-5781
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JASVINDER BADWALZ
Credential	:
Telephone Number	:	915-779-5781

Provider Enumeration Date	:	04/27/2023
Last Update Date	:	04/27/2023

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