Provider Demographics
NPI:1417354358
Name:SANDEEP KAUR, DDS, PC
Entity Type:Organization
Organization Name:SANDEEP KAUR, DDS, PC
Other - Org Name:SUNRISE VALLEY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-787-9670
Mailing Address - Street 1:12950 HIGHLAND CROSSING DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-5888
Mailing Address - Country:US
Mailing Address - Phone:703-787-9670
Mailing Address - Fax:703-787-9672
Practice Address - Street 1:12950 HIGHLAND CROSSING DR
Practice Address - Street 2:SUITE F
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-5888
Practice Address - Country:US
Practice Address - Phone:703-787-9670
Practice Address - Fax:703-787-9672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-20
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401414567122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty