Provider Demographics
NPI:1871625616
Name:SAHNI, PAUL S (DMD, MSD, PC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:S
Last Name:SAHNI
Suffix:
Gender:M
Credentials:DMD, MSD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W SPRINGFIELD AVE
Mailing Address - Street 2:SUITE 901
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-4834
Mailing Address - Country:US
Mailing Address - Phone:217-351-1701
Mailing Address - Fax:217-351-1703
Practice Address - Street 1:201 W SPRINGFIELD AVE
Practice Address - Street 2:SUITE 901
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-4834
Practice Address - Country:US
Practice Address - Phone:217-351-1701
Practice Address - Fax:217-351-1703
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics