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Provider Information for 1518216415



DR. JAGANDEEP SINGH BAJWA D.M.D.

Other Name:   JASON BAJWA
Gender: MALE

Individual NPI: 1518216415

Calendar Last Updated: 2013-08-13

Details

Name Value
NPI 1518216415
Enumeration Date 2012-09-06
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 924 E SAN CARLOS WAY
CHANDLER, AZ 85249-3032
United States

Phone: 480-358-8445 | Fax: 480-986-4125
View Map External Link
Primary Practice Address 5355 W CHANDLER BLVD SUITE 1
CHANDLER, AZ 85226-8603
United States

Phone: 480-961-4888 | Fax:
View Map External Link
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice AZ D008417
Other Identifiers
Issuer State Number
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location