Provider Demographics
NPI:1447666078
Name:RUPINDER CHAHAL DDS INC
Entity type:Organization
Organization Name:RUPINDER CHAHAL DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUPINDER
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHAHAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:209-633-1200
Mailing Address - Street 1:605 STANDIFORD AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-1000
Mailing Address - Country:US
Mailing Address - Phone:209-633-1200
Mailing Address - Fax:
Practice Address - Street 1:605 STANDIFORD AVE
Practice Address - Street 2:SUITE G
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-1000
Practice Address - Country:US
Practice Address - Phone:209-633-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-03
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA515991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty