Provider Demographics
NPI:1134653744
Name:SACHDEV, CHITWAN (DDS)
Entity Type:Individual
Prefix:
First Name:CHITWAN
Middle Name:
Last Name:SACHDEV
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MARTIN LUTHER KING BLVD
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-1152
Mailing Address - Country:US
Mailing Address - Phone:940-766-6306
Mailing Address - Fax:940-766-6504
Practice Address - Street 1:8340 COLERAIN AVE STE 1
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-3916
Practice Address - Country:US
Practice Address - Phone:513-385-5999
Practice Address - Fax:913-752-9116
Is Sole Proprietor?:No
Enumeration Date:2017-04-20
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012899A122300000X
TX32703122300000X
OH30025320122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist