Provider Demographics
NPI:1881904258
Name:SIDHU, SUKHDEV SINGH (DDS)
Entity type:Individual
Prefix:DR
First Name:SUKHDEV
Middle Name:SINGH
Last Name:SIDHU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2500 NE GREEN OAKS BLVD
Mailing Address - Street 2:STE. 102
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-3002
Mailing Address - Country:US
Mailing Address - Phone:817-633-4444
Mailing Address - Fax:817-549-4239
Practice Address - Street 1:2500 NE GREEN OAKS BLVD
Practice Address - Street 2:STE. 102
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-3002
Practice Address - Country:US
Practice Address - Phone:817-633-4444
Practice Address - Fax:817-549-4239
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX295841223G0001X, 1223S0112X, 1223D0004X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral Practice
Yes1223D0004XDental ProvidersDentistDental Anesthesiology