Provider Demographics
NPI:1811320823
Name:SIDHU, NAVREET K (DDS)
Entity type:Individual
Prefix:MRS
First Name:NAVREET
Middle Name:K
Last Name:SIDHU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1299 CORPORATE DRIVE
Mailing Address - Street 2:APT #2117
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590
Mailing Address - Country:US
Mailing Address - Phone:310-666-5992
Mailing Address - Fax:
Practice Address - Street 1:1701 SUNRISE HWY, SPACE NO. C7
Practice Address - Street 2:GREAT EXPRESSIONS DENTAL CENTER
Practice Address - City:BAYSHORE
Practice Address - State:NY
Practice Address - Zip Code:11706
Practice Address - Country:US
Practice Address - Phone:631-666-1440
Practice Address - Fax:631-665-0033
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056776122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist