Provider Demographics
NPI:1548758113
Name:SANDHU, NISHA KAUR (BDS BS)
Entity Type:Individual
Prefix:DR
First Name:NISHA
Middle Name:KAUR
Last Name:SANDHU
Suffix:
Gender:F
Credentials:BDS BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2224 KAMBER RD
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-6229
Mailing Address - Country:US
Mailing Address - Phone:425-829-3542
Mailing Address - Fax:
Practice Address - Street 1:535 BROADWAY E AVENUE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-5023
Practice Address - Country:US
Practice Address - Phone:206-829-4333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-28
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WA609891461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty