Provider Demographics
NPI:1861688400
Name:BATRA, JASBIR S (DDS)
Entity type:Individual
Prefix:DR
First Name:JASBIR
Middle Name:S
Last Name:BATRA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 E SAN ANTONIO DR
Mailing Address - Street 2:SUITE 10
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2210
Mailing Address - Country:US
Mailing Address - Phone:562-428-4678
Mailing Address - Fax:562-268-9320
Practice Address - Street 1:925 E SAN ANTONIO DR
Practice Address - Street 2:SUITE 10
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2210
Practice Address - Country:US
Practice Address - Phone:562-428-4678
Practice Address - Fax:562-268-9320
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA263371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice