Healthcare Provider Details

I. General information

NPI: 1023937612
Provider Name (Legal Business Name): SANDEEP KAUR DANDIWAL DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

201 SAINT JOHNS CHURCH RD
CAMP HILL PA
17011-4049
US

IV. Provider business mailing address

175 WARM SUNDAY WAY
MECHANICSBURG PA
17050-3801
US

V. Phone/Fax

Practice location:
  • Phone: 717-737-4337
  • Fax:
Mailing address:
  • Phone: 717-779-7309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS046005
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: