MEDICARE: DR. SUKHJINDER K SANDHU DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	053997	NY

General Provider Information

NPI Number	:	1619125184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUKHJINDER K SANDHU DDS

Provider Business Mailing Address
First Line	:	1 FRANKLIN TOWN BLVD
Second Line	:	APT 1801
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-1240
Country	:	US
Telephone Number	:	646-346-9058
Fax Number	:

Provider Business Practice Location Address
First Line	:	910 GRAND CONCOURSE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-2719
Country	:	US
Telephone Number	:	718-538-2410
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2008
Last Update Date	:	09/08/2008

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