Healthcare Provider Details

I. General information

NPI: 1881982536
Provider Name (Legal Business Name): SANDEEP TEOTIA D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2011
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4432 ROUTE 27
KINGSTON NJ
08528-9613
US

IV. Provider business mailing address

1330 PARKWAY AVE
EWING NJ
08628-3006
US

V. Phone/Fax

Practice location:
  • Phone: 609-497-0808
  • Fax: 609-497-0330
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number24758
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: