Provider Demographics
NPI:1619125184
Name:SANDHU, SUKHJINDER K (DDS)
Entity type:Individual
Prefix:DR
First Name:SUKHJINDER
Middle Name:K
Last Name:SANDHU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FRANKLIN TOWN BLVD
Mailing Address - Street 2:APT 1801
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-1240
Mailing Address - Country:US
Mailing Address - Phone:646-346-9058
Mailing Address - Fax:
Practice Address - Street 1:910 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-2719
Practice Address - Country:US
Practice Address - Phone:718-538-2410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0539971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice