Provider Demographics
NPI:1306039128
Name:DEEPAK K SACHDEV DDS INC.
Entity Type:Organization
Organization Name:DEEPAK K SACHDEV DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEPAK
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:SACHDEV
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:650-573-6500
Mailing Address - Street 1:1415 S ELCAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402
Mailing Address - Country:US
Mailing Address - Phone:650-573-6500
Mailing Address - Fax:650-573-6500
Practice Address - Street 1:1415 S EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-3019
Practice Address - Country:US
Practice Address - Phone:650-573-6500
Practice Address - Fax:650-573-6500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB41534-01OtherMEDI-CAL