Provider Demographics
NPI:1801415948
Name:SANDHU, MANMIT (DMD)
Entity Type:Individual
Prefix:
First Name:MANMIT
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 1:15500 W HIGHWAY 71 STE 300
Mailing Address - Street 2:
Mailing Address - City:BEE CAVE
Mailing Address - State:TX
Mailing Address - Zip Code:78738-2819
Mailing Address - Country:US
Mailing Address - Phone:512-900-2017
Mailing Address - Fax:
Practice Address - Street 1:15500 W HIGHWAY 71 STE 300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78738-2819
Practice Address - Country:US
Practice Address - Phone:512-900-2017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX388381223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry