Provider Demographics
NPI:1902284516
Name:TAGGAR, TANJIT (DMD)
Entity Type:Individual
Prefix:DR
First Name:TANJIT
Middle Name:
Last Name:TAGGAR
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 1:2024 CHESTERFIELD AVE APT 109
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-0013
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 LEIGH FARM RD
Practice Address - Street 2:APARTMENT 109
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-8110
Practice Address - Country:US
Practice Address - Phone:908-938-5998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-14
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC136051223E0200X
VA04014143601223G0001X
NC1509541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223E0200XDental ProvidersDentistEndodontics