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NPI Code Detail

MEDICARE: MANDEEP K SIDHU DDS

MEDICARE: MANDEEP K SIDHU 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
11223G0001XGeneral Practice Dentistry55935CA

General Provider Information

NPI Number : 1740401439
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANDEEP K SIDHU DDS
Provider Business Mailing Address
First Line : 22012 SEVILLA RD APT 97
Second Line :
City : HAYWARD
State : CA
Zip : 94541-2737
Country : US
Telephone Number : 408-712-8865
Fax Number :
Provider Business Practice Location Address
First Line : 975 VETERANS BLVD
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94063-1714
Country : US
Telephone Number : 650-365-8900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 07/08/2007

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Directions to “ MANDEEP K SIDHU DDS” Practice Location

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