Provider Demographics
NPI:1538744917
Name:CHEEMA DENTAL CORPORATION
Entity type:Organization
Organization Name:CHEEMA DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASBIR
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHEEMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-824-1940
Mailing Address - Street 1:3150 SANTA RITA RD STE A
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-8300
Mailing Address - Country:US
Mailing Address - Phone:925-201-3917
Mailing Address - Fax:
Practice Address - Street 1:3150 SANTA RITA RD STE A
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-8300
Practice Address - Country:US
Practice Address - Phone:925-201-3917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHEEMA DENTAL CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-16
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty