MEDICARE: DR. SADREDINE SHADMAN DMD

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	053684	NY

General Provider Information

NPI Number	:	1871775312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SADREDINE SHADMAN DMD

Provider Business Mailing Address
First Line	:	140 W END AVE APT 25D
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-6137
Country	:	US
Telephone Number	:	917-292-5945
Fax Number	:

Provider Business Practice Location Address
First Line	:	503 S BROADWAY STE 210
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10705-6202
Country	:	US
Telephone Number	:	914-965-9771
Fax Number	:

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

Provider Enumeration Date	:	11/27/2007
Last Update Date	:	12/01/2025

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