Provider Demographics
NPI:1144684275
Name:CHEEMA DENTAL CORPORATION
Entity type:Organization
Organization Name:CHEEMA DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASBIR
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHEEMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:209-594-0485
Mailing Address - Street 1:1268 W LATHROP RD
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95336-9671
Mailing Address - Country:US
Mailing Address - Phone:209-478-6000
Mailing Address - Fax:209-332-5694
Practice Address - Street 1:1268 W LATHROP RD
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-9671
Practice Address - Country:US
Practice Address - Phone:209-478-6000
Practice Address - Fax:209-332-5694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-05
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty