=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588398457
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GARIMA SANDHU
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2022
-----------------------------------------------------
Last Update Date | 12/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4109 HILLCREST PLZ
-----------------------------------------------------
City | VERNON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76384-3267
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-552-2269
-----------------------------------------------------
Fax | 940-552-2418
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4109 HILLCREST PLZ
-----------------------------------------------------
City | VERNON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76384-3267
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-552-2269
-----------------------------------------------------
Fax | 940-552-2418
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 38719
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------