Healthcare Provider Details

I. General information

NPI: 1134420698
Provider Name (Legal Business Name): SHIBANI SEHGAL DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2010
Last Update Date: 11/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 E RANCH RD
SACRAMENTO CA
95825-6411
US

IV. Provider business mailing address

612 E RANCH RD
SACRAMENTO CA
95825-6411
US

V. Phone/Fax

Practice location:
  • Phone: 916-993-8959
  • Fax:
Mailing address:
  • Phone: 916-993-8959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number59951
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: