Provider Demographics
NPI:1659752178
Name:SANDHU, RIMPLE (DMD)
Entity Type:Individual
Prefix:DR
First Name:RIMPLE
Middle Name:
Last Name:SANDHU
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2489 DISCOVERY BAY BLVD. #400
Mailing Address - Street 2:
Mailing Address - City:DISCOVERY BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94505
Mailing Address - Country:US
Mailing Address - Phone:484-437-1559
Mailing Address - Fax:925-679-7110
Practice Address - Street 1:2489 DISCOVERY BAY BLVD. #400
Practice Address - Street 2:
Practice Address - City:DISCOVERY BAY
Practice Address - State:CA
Practice Address - Zip Code:94505
Practice Address - Country:US
Practice Address - Phone:484-437-1559
Practice Address - Fax:925-679-7110
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-10
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1020581223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics