Provider Demographics
NPI:1770649501
Name:WILKHU, CHANDANDEEP SINGH (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHANDANDEEP
Middle Name:SINGH
Last Name:WILKHU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 MCLEOD ST
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-3463
Mailing Address - Country:US
Mailing Address - Phone:321-459-2444
Mailing Address - Fax:321-453-8508
Practice Address - Street 1:231 MCLEOD ST
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-3463
Practice Address - Country:US
Practice Address - Phone:321-459-2444
Practice Address - Fax:321-453-8508
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL164981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice