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General NPI Number Information
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NPI Number | 1750414629
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Entity Type | Individual
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Provider Name | KANWAR DEEP SINGH SACHDEVA D.M.D., M.S.D.
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Gender | Male
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 924 EMILY WAY
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City | MADERA
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State | CA
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Zip | 93637-5647
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Country | US
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Telephone | 559-232-3737
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Fax | 559-675-8541
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Provider Business Mailing Address
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Address Line | 11229 N VIA PALERMO WAY
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City | FRESNO
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State | CA
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Zip | 93730-8815
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Country | US
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Telephone | 559-840-3377
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 20551
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 58355
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License Number State | CA
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