Healthcare Provider Details

I. General information

NPI: 1326224924
Provider Name (Legal Business Name): GURSIMRAT K. SEKHON D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 05/27/2020
Certification Date: 05/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9571 LAGUNA SPRINGS DR. STE. 100
ELK GROVE CA
95758
US

IV. Provider business mailing address

9571 LAGUNA SPRINGS DR. STE 100
ELK GROVE CA
95758
US

V. Phone/Fax

Practice location:
  • Phone: 916-691-1659
  • Fax: 916-691-0976
Mailing address:
  • Phone: 916-691-1650
  • Fax: 916-691-0976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number50820
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: