Provider Demographics
NPI:1235933177
Name:SINGH, SAMEERA
Entity type:Individual
Prefix:
First Name:SAMEERA
Middle Name:
Last Name:SINGH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 GREWAL PKWY APT 323
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-8016
Mailing Address - Country:US
Mailing Address - Phone:415-528-0288
Mailing Address - Fax:
Practice Address - Street 1:2600 S TRACY BLVD STE 170
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-9111
Practice Address - Country:US
Practice Address - Phone:415-528-0288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1091011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice