Provider Demographics
NPI:1558046052
Name:HEGDE, SANCHITH (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANCHITH
Middle Name:
Last Name:HEGDE
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 1:3302 GASTON AVE # 159A
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2013
Mailing Address - Country:US
Mailing Address - Phone:760-815-9393
Mailing Address - Fax:214-874-4527
Practice Address - Street 1:3302 GASTON AVE # 159A
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2013
Practice Address - Country:US
Practice Address - Phone:760-815-9393
Practice Address - Fax:214-874-4527
Is Sole Proprietor?:No
Enumeration Date:2023-06-21
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40114122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist