Provider Demographics
NPI:1679989750
Name:DHILLON, JAPNEET SINGH
Entity type:Individual
Prefix:
First Name:JAPNEET
Middle Name:SINGH
Last Name:DHILLON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JAPNEET
Other - Middle Name:
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15366 S HARLAN RD
Mailing Address - Street 2:
Mailing Address - City:LATHROP
Mailing Address - State:CA
Mailing Address - Zip Code:95330-8732
Mailing Address - Country:US
Mailing Address - Phone:209-556-2967
Mailing Address - Fax:
Practice Address - Street 1:15366 S HARLAN RD
Practice Address - Street 2:
Practice Address - City:LATHROP
Practice Address - State:CA
Practice Address - Zip Code:95330-8732
Practice Address - Country:US
Practice Address - Phone:209-556-2967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-09
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA635801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice