Provider Demographics
NPI:1902239957
Name:BAJWA, JASHANJOT SINGH (DMD)
Entity Type:Individual
Prefix:DR
First Name:JASHANJOT
Middle Name:SINGH
Last Name:BAJWA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 E LAWRENCE RD
Mailing Address - Street 2:TIOGA DENTAL SERVICES
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16929-8801
Mailing Address - Country:US
Mailing Address - Phone:570-827-0145
Mailing Address - Fax:
Practice Address - Street 1:34 E LAWRENCE RD
Practice Address - Street 2:TIOGA DENTAL SERVICES
Practice Address - City:LAWRENCEVILLE
Practice Address - State:PA
Practice Address - Zip Code:16929-8801
Practice Address - Country:US
Practice Address - Phone:570-827-0145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0398671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice