Provider Demographics
NPI:1629557632
Name:NAVJOT SINGH SIDHU BDS PLLC DBA SUNSET SQUARE DENTAL
Entity Type:Organization
Organization Name:NAVJOT SINGH SIDHU BDS PLLC DBA SUNSET SQUARE DENTAL
Other - Org Name:SUNSET SQUARE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAVJOT
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:SIDHU
Authorized Official - Suffix:
Authorized Official - Credentials:BDS
Authorized Official - Phone:360-255-5000
Mailing Address - Street 1:1225 E SUNSET DR STE 140
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-1817
Mailing Address - Country:US
Mailing Address - Phone:360-255-5000
Mailing Address - Fax:360-225-5001
Practice Address - Street 1:1225 E SUNSET DR STE 140
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-1817
Practice Address - Country:US
Practice Address - Phone:360-255-5000
Practice Address - Fax:360-225-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60295933261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental