Provider Demographics
NPI:1235641911
Name:SACHDEV, KANIKA (DMD)
Entity Type:Individual
Prefix:
First Name:KANIKA
Middle Name:
Last Name:SACHDEV
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5330 E MOCKINGBIRD LN STE 120
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-0941
Mailing Address - Country:US
Mailing Address - Phone:214-821-6468
Mailing Address - Fax:
Practice Address - Street 1:5330 E MOCKINGBIRD LN STE 120
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-0941
Practice Address - Country:US
Practice Address - Phone:214-821-6468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33595122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist