Provider Demographics
NPI:1417476177
Name:SACHDEVA, HEMANT (DDS)
Entity Type:Individual
Prefix:DR
First Name:HEMANT
Middle Name:
Last Name:SACHDEVA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4921 W ATHENS AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-2118
Mailing Address - Country:US
Mailing Address - Phone:559-824-5029
Mailing Address - Fax:
Practice Address - Street 1:1975 GARNET AVE STE E
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-3594
Practice Address - Country:US
Practice Address - Phone:858-866-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-13
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1016671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice