Provider Demographics
NPI:1548831969
Name:SANDHU, NAVNEET SINGH
Entity type:Individual
Prefix:
First Name:NAVNEET SINGH
Middle Name:
Last Name:SANDHU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 N TOUCHET ST
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-1279
Mailing Address - Country:US
Mailing Address - Phone:716-313-8493
Mailing Address - Fax:
Practice Address - Street 1:2356 TAUMARSON RD
Practice Address - Street 2:
Practice Address - City:COLLEGE PLACE
Practice Address - State:WA
Practice Address - Zip Code:99324-1300
Practice Address - Country:US
Practice Address - Phone:509-956-3321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61173676122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist