Provider Demographics
NPI:1275552945
Name:SAHIWAL, INDIRA GILL (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:INDIRA
Middle Name:GILL
Last Name:SAHIWAL
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:3301 EL CAMINO REAL STE 102
Mailing Address - Street 2:
Mailing Address - City:ATHERTON
Mailing Address - State:CA
Mailing Address - Zip Code:94027-3803
Mailing Address - Country:US
Mailing Address - Phone:650-299-1480
Mailing Address - Fax:650-299-1482
Practice Address - Street 1:3301 EL CAMINO REAL
Practice Address - Street 2:SUITE 102
Practice Address - City:ATHERTON
Practice Address - State:CA
Practice Address - Zip Code:94027-3803
Practice Address - Country:US
Practice Address - Phone:650-299-1480
Practice Address - Fax:650-299-1482
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA476591223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics