Individual provider Active NPI

Rohtaz Kaur Sandhu, DDS

  • General Practice Dentistry
  • Fort Campbell, KY
National Provider Identifier
1477862845
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901020302 Issued in MI
Practice address
2441 21St St
US Army Dental Activity
Fort Campbell, KY 42223-5582
Phone
(270) 798-8977
Fax
(270) 956-0266
NPI assigned
Oct 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020302 MI
General Practice Dentistry 1223G0001X 2901020302 MI Primary

Addresses

Primary practice location

2441 21St St
US Army Dental Activity
Fort Campbell, KY 42223-5582

Mailing address

2441 21St St
US Army Dental Activity
Fort Campbell, KY 42223-5582
Phone (270) 798-8751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901020302MIMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1285891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1477862845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 21ST ST",
            "address_2": "US ARMY DENTAL ACTIVITY",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235582",
            "telephone_number": "270-798-8751",
            "fax_number": "270-956-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 21ST ST",
            "address_2": "US ARMY DENTAL ACTIVITY",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235582",
            "telephone_number": "270-798-8977",
            "fax_number": "270-956-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDHU",
        "first_name": "ROHTAZ",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-01",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020302",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Campbell, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.