Provider Demographics
NPI:1154719185
Name:SIDHU, PREETI (DMD)
Entity type:Individual
Prefix:
First Name:PREETI
Middle Name:
Last Name:SIDHU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5518 KING PLAINS CREEK LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-7067
Mailing Address - Country:US
Mailing Address - Phone:617-304-1997
Mailing Address - Fax:
Practice Address - Street 1:2811 BUSINESS CENTER DR STE 105
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-4161
Practice Address - Country:US
Practice Address - Phone:713-340-1418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-29
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX285151223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics