Provider Demographics
NPI:1225419658
Name:OTHMAN, SHEILA (DMD, MPH)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:OTHMAN
Suffix:
Gender:F
Credentials:DMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20680 SENECA MEADOWS PKWY STE 207
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-7029
Mailing Address - Country:US
Mailing Address - Phone:480-280-0224
Mailing Address - Fax:
Practice Address - Street 1:20680 SENECA MEADOWS PKWY STE 207
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-7029
Practice Address - Country:US
Practice Address - Phone:301-515-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PADS0416151223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program