Provider Demographics
NPI:1295310456
Name:SINGH, AJITESH (DDS)
Entity type:Individual
Prefix:
First Name:AJITESH
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 WALKERS BROOK DR
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-3238
Mailing Address - Country:US
Mailing Address - Phone:310-634-2856
Mailing Address - Fax:
Practice Address - Street 1:9870 CARROLL CANYON RD APT 115
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1166
Practice Address - Country:US
Practice Address - Phone:619-704-2508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18597051223P0300X
390200000X
CA1102021223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program