Healthcare Provider Details

I. General information

NPI: 1518034511
Provider Name (Legal Business Name): SARANDEEP S HUJA DDS, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 01/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST RM D406 UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY
LEXINGTON KY
40536-0297
US

IV. Provider business mailing address

800 ROSE ST RM D104 UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY
LEXINGTON KY
40536-0297
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5371
  • Fax:
Mailing address:
  • Phone: 859-257-2760
  • Fax: 859-257-5859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number21455
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number9125
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: