Provider Demographics
NPI:1023287539
Name:SIDHU, HARJIND SINGH (DDS)
Entity type:Individual
Prefix:DR
First Name:HARJIND
Middle Name:SINGH
Last Name:SIDHU
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 1:3261 S SEPULVEDA BLVD
Mailing Address - Street 2:APT 207
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-5217
Mailing Address - Country:US
Mailing Address - Phone:415-573-7765
Mailing Address - Fax:
Practice Address - Street 1:3261 S SEPULVEDA BLVD
Practice Address - Street 2:APT 207
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-5217
Practice Address - Country:US
Practice Address - Phone:415-573-7765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55999122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist