Provider Demographics
NPI:1639620594
Name:SANDHU, SUKHPREET KAUR
Entity type:Individual
Prefix:
First Name:SUKHPREET
Middle Name:KAUR
Last Name:SANDHU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 WHITE RANCH CIR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-4743
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:44066 MARGARITA RD
Practice Address - Street 2:SUITE #1
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-2779
Practice Address - Country:US
Practice Address - Phone:951-302-6222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-17
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100756122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist