Healthcare Provider Details

I. General information

NPI: 1013144351
Provider Name (Legal Business Name): SURBHI SEHGAL D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2009
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 OLANDWOOD CT STE 104
OLNEY MD
20832-1485
US

IV. Provider business mailing address

3401 OLANDWOOD CT STE 104
OLNEY MD
20832-1485
US

V. Phone/Fax

Practice location:
  • Phone: 301-774-6200
  • Fax: 301-774-1272
Mailing address:
  • Phone: 301-774-6200
  • Fax: 301-774-1272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number16543
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: