MEDICARE: DR. SHEELA KUDCHADKER DDS MS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	20562	TX

General Provider Information

NPI Number	:	1124110861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHEELA KUDCHADKER DDS MS PA

Provider Business Mailing Address
First Line	:	9415 BROADWAY
Second Line	:	STE 119
City	:	PEARLAND
State	:	TX
Zip	:	77584-8094
Country	:	US
Telephone Number	:	281-436-8877
Fax Number	:	281-854-2925

Provider Business Practice Location Address
First Line	:	9415 BROADWAY
Second Line	:	STE 119
City	:	PEARLAND
State	:	TX
Zip	:	77584-8094
Country	:	US
Telephone Number	:	281-436-8877
Fax Number	:	281-854-2925

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	07/08/2007

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