Healthcare Provider Details
I. General information
NPI: 1902258437
Provider Name (Legal Business Name): SHUBKARMAN SEKHON D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/08/2016
Last Update Date: 06/29/2022
Certification Date: 06/20/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2430 SUITE 210 I-35E
DENTON TX
76210
US
IV. Provider business mailing address
5234 N O CONNOR BLVD APT 3501
IRVING TX
75039-5736
US
V. Phone/Fax
- Phone: 940-202-0419
- Fax:
- Phone: 214-770-1981
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | DS040920 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | 33312 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: