MEDICARE: MADIHA FATIMA DDS

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	DDS112031	CA

General Provider Information

NPI Number	:	1801773577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADIHA FATIMA DDS

Provider Business Mailing Address
First Line	:	3300 CAPITAL CENTER DR APT 22
Second Line	:
City	:	RANCHO CORDOVA
State	:	CA
Zip	:	95670-7972
Country	:	US
Telephone Number	:	916-835-8985
Fax Number	:

Provider Business Practice Location Address
First Line	:	4022 SUNRISE BLVD STE 160
Second Line	:
City	:	RANCHO CORDOVA
State	:	CA
Zip	:	95742-6908
Country	:	US
Telephone Number	:	916-246-1108
Fax Number	:

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

Provider Enumeration Date	:	08/16/2025
Last Update Date	:	08/16/2025

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