MEDICARE: SIMRAT SEHMI

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	122300000X	Dentist	0401415303	VA

General Provider Information

NPI Number	:	1184073306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMRAT SEHMI

Provider Business Mailing Address
First Line	:	10039 JEFFERSON DAVIS HWY
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22407-9418
Country	:	US
Telephone Number	:	540-898-8998
Fax Number	:

Provider Business Practice Location Address
First Line	:	10039 JEFFERSON DAVIS HWY
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22407-9418
Country	:	US
Telephone Number	:	540-898-8998
Fax Number	:

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

Provider Enumeration Date	:	06/08/2016
Last Update Date	:	06/30/2016

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