Healthcare Provider Details

I. General information

NPI: 1013830819
Provider Name (Legal Business Name): NAVJEET SINGH SANDHU DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5542 W FOND DU LAC AVE
MILWAUKEE WI
53216-1200
US

IV. Provider business mailing address

626 E STATE ST APT 1603
MILWAUKEE WI
53202-3252
US

V. Phone/Fax

Practice location:
  • Phone: 414-240-0935
  • Fax:
Mailing address:
  • Phone: 951-233-0431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6002224-15
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: