Provider Demographics
NPI:1265681373
Name:ALLEN, SHEENA LOUISE (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHEENA
Middle Name:LOUISE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MISS
Other - First Name:SHEENA
Other - Middle Name:LOUISE
Other - Last Name:OLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:2100 ROSS AVE STE 960
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-7908
Mailing Address - Country:US
Mailing Address - Phone:214-999-0110
Mailing Address - Fax:214-999-0110
Practice Address - Street 1:2100 ROSS AVE STE 960
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-7908
Practice Address - Country:US
Practice Address - Phone:214-999-0110
Practice Address - Fax:214-999-0110
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-12
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019926122300000X, 1223P0700X
TX32579122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No122300000XDental ProvidersDentist