Provider Demographics
NPI:1235512724
Name:SHEIKH, SADIA
Entity Type:Individual
Prefix:
First Name:SADIA
Middle Name:
Last Name:SHEIKH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3504 INVERNESS DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-6325
Mailing Address - Country:US
Mailing Address - Phone:201-982-4441
Mailing Address - Fax:
Practice Address - Street 1:203 HOOPER AVE
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7607
Practice Address - Country:US
Practice Address - Phone:173-224-4807
Practice Address - Fax:732-244-8078
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ22DI026449001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program