Provider Demographics
NPI:1417363359
Name:SEHGAL, SIDDARTH (DMD)
Entity Type:Individual
Prefix:DR
First Name:SIDDARTH
Middle Name:
Last Name:SEHGAL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24600 MILLSTREAM DR # 440
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-3511
Mailing Address - Country:US
Mailing Address - Phone:703-559-8550
Mailing Address - Fax:
Practice Address - Street 1:24600 MILLSTREAM DR # 440
Practice Address - Street 2:
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105-3511
Practice Address - Country:US
Practice Address - Phone:703-559-8550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-10
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014166811223E0200X
NC98081223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics