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General NPI Number Information
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NPI Number | 1811320823
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Entity Type | Individual
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Provider Name | NAVREET K SIDHU DDS
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Gender | Female
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Dates
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Enumeration Date | 08/13/2013
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Last Update Date | 08/13/2013
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Provider Practice Location Address
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Address Line | 1701 SUNRISE HWY, SPACE NO. C7 GREAT EXPRESSIONS DENTAL CENTER
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City | BAYSHORE
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State | NY
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Zip | 11706
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Country | US
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Telephone | 631-666-1440
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Fax | 631-665-0033
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Provider Business Mailing Address
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Address Line | 1299 CORPORATE DRIVE APT #2117
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City | WESTBURY
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State | NY
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Zip | 11590
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Country | US
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Telephone | 310-666-5992
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 056776
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License Number State | NY
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