Provider Demographics
NPI:1104305374
Name:SANGHA, HARJOT KAUR (DMD)
Entity type:Individual
Prefix:DR
First Name:HARJOT
Middle Name:KAUR
Last Name:SANGHA
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 1:2561 CLUBHOUSE DR W
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5702
Mailing Address - Country:US
Mailing Address - Phone:630-689-6566
Mailing Address - Fax:
Practice Address - Street 1:2119 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-1211
Practice Address - Country:US
Practice Address - Phone:707-257-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1029261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice