Provider Demographics
NPI:1487039509
Name:DHERI, TEJINDER (DDS)
Entity Type:Individual
Prefix:
First Name:TEJINDER
Middle Name:
Last Name:DHERI
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 1:3375 BRANDYWINE CT
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-9077
Mailing Address - Country:US
Mailing Address - Phone:530-755-6087
Mailing Address - Fax:
Practice Address - Street 1:1047 LIVE OAK BLVD
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3443
Practice Address - Country:US
Practice Address - Phone:530-673-7171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-30
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040487122300000X
CA63013122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist