Provider Demographics
NPI:1689386559
Name:JOHAL, SHUBHSANGEET KAUR (DMD)
Entity type:Individual
Prefix:
First Name:SHUBHSANGEET
Middle Name:KAUR
Last Name:JOHAL
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 1:50 ELDON AVE
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-1815
Mailing Address - Country:US
Mailing Address - Phone:407-684-9254
Mailing Address - Fax:
Practice Address - Street 1:9027 W CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-1107
Practice Address - Country:US
Practice Address - Phone:610-880-3916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-21
Last Update Date:2025-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0452241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice