Healthcare Provider Details

I. General information

NPI: 1538728654
Provider Name (Legal Business Name): TANYA SEHGAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2019
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 3RD ST SW
WINTER HAVEN FL
33880-3419
US

IV. Provider business mailing address

727 3RD ST SW
WINTER HAVEN FL
33880-3419
US

V. Phone/Fax

Practice location:
  • Phone: 863-282-2053
  • Fax: 863-226-0238
Mailing address:
  • Phone: 863-282-2053
  • Fax: 863-226-0238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDN24269
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: