Basic Information
| Provider Information | |||||||||
| NPI: | 1821344532 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEHGAL | ||||||||
| FirstName: | SUMIT | ||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16 HORSESHOE LN | ||||||||
| Address2: | |||||||||
| City: | LEVITTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117561112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5162364415 | ||||||||
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| Practice Location | |||||||||
| Address1: | 133 SCOVILL ST STE 213 | ||||||||
| Address2: | |||||||||
| City: | WATERBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 067061127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037097055 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2012 | ||||||||
| LastUpdateDate: | 05/11/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 1223G0001X | 056837 | NY | Y | Dental Providers | Dentist | General Practice |
No ID Information.