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General NPI Number Information
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NPI Number | 1881079564
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Entity Type | Individual
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Provider Name | SHEEDEH MADANI MS, DMD
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Gender | Female
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Dates
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Enumeration Date | 07/23/2015
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 15 N PRESIDENTIAL BLVD STE 303
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1022
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Country | US
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Telephone | 610-336-8478
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Fax |
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Provider Business Mailing Address
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Address Line | 600 PORTLEDGE DR
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City | BRYN MAWR
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State | PA
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Zip | 19010-1154
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Country | US
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Telephone | 610-496-0745
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DS040852
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License Number State | PA
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