Healthcare Provider Details

I. General information

NPI: 1104757376
Provider Name (Legal Business Name): SUKHPREET KAUR SANDHU DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 FULLERTON AVE STE 220
CORONA CA
92881-3147
US

IV. Provider business mailing address

1820 FULLERTON AVE STE 220
CORONA CA
92881-3147
US

V. Phone/Fax

Practice location:
  • Phone: 703-470-6595
  • Fax:
Mailing address:
  • Phone: 703-470-6595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. SUKHPREET KAUR SANDHU
Title or Position: OWNER
Credential: DDS
Phone: 703-470-6595