Provider Demographics
NPI:1225450158
Name:SANDHU, HENNA (DDS)
Entity Type:Individual
Prefix:
First Name:HENNA
Middle Name:
Last Name:SANDHU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7252 VILLAGE PKWY
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2030
Mailing Address - Country:US
Mailing Address - Phone:925-828-4133
Mailing Address - Fax:
Practice Address - Street 1:7252 VILLAGE PKWY
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2030
Practice Address - Country:US
Practice Address - Phone:925-828-4133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-12
Last Update Date:2014-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56737122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist