Provider Demographics
NPI:1447907043
Name:SIDHU, ARUNDEEP KAUR (DDS)
Entity type:Individual
Prefix:DR
First Name:ARUNDEEP
Middle Name:KAUR
Last Name:SIDHU
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1871 PETITE SYRAH LN
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-6684
Mailing Address - Country:US
Mailing Address - Phone:209-617-4155
Mailing Address - Fax:
Practice Address - Street 1:3635 N FREEWAY BLVD STE 110
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-2926
Practice Address - Country:US
Practice Address - Phone:096-174-1552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-04
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107309122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty