Provider Demographics
NPI:1295849586
Name:SACHDEVA-MUNK, RADHA (DDS)
Entity Type:Individual
Prefix:DR
First Name:RADHA
Middle Name:
Last Name:SACHDEVA-MUNK
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 1:154 TERRY RD
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-5103
Mailing Address - Country:US
Mailing Address - Phone:631-724-4220
Mailing Address - Fax:631-361-6428
Practice Address - Street 1:154 TERRY RD
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-5103
Practice Address - Country:US
Practice Address - Phone:631-724-4220
Practice Address - Fax:631-361-6428
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0473901122300000X
NY048570122300000X
NY0467872122300000X
NY047390122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist