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General NPI Number Information
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NPI Number | 1942936372
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Entity Type | Individual
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Provider Name | ANDEEP SANGHA
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Gender | Female
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Dates
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Enumeration Date | 07/27/2022
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 3246 W GRANT LINE RD
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City | TRACY
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State | CA
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Zip | 95304-8427
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Country | US
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Telephone | 209-213-7808
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Fax |
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Provider Business Mailing Address
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Address Line | 2473 DETERT ST
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City | LIVERMORE
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State | CA
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Zip | 94550-2515
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Country | US
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Telephone | 317-997-1769
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12013845A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 109422
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12013845A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 109422
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License Number State | CA
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