MEDICARE: SHEBA NEEDAM-THOMAS RDH

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	124Q00000X	Dental Hygienist	6157	MD

General Provider Information

NPI Number	:	1457216582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEBA NEEDAM-THOMAS RDH

Provider Business Mailing Address
First Line	:	111 SPRING AVE
Second Line	:
City	:	CHESTERTOWN
State	:	MD
Zip	:	21620-1342
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 SPRING AVE
Second Line	:
City	:	CHESTERTOWN
State	:	MD
Zip	:	21620-1342
Country	:	US
Telephone Number	:	410-778-2017
Fax Number	:

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

Provider Enumeration Date	:	12/20/2025
Last Update Date	:	12/20/2025

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