Provider Demographics
NPI:1356932354
Name:SANDHU, KARAN RAJ SINGH
Entity type:Individual
Prefix:
First Name:KARAN
Middle Name:RAJ SINGH
Last Name:SANDHU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3438 GULF FWY
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-4119
Mailing Address - Country:US
Mailing Address - Phone:281-720-3500
Mailing Address - Fax:
Practice Address - Street 1:3438 GULF FWY
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-4119
Practice Address - Country:US
Practice Address - Phone:281-720-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX370101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice