Provider Demographics
NPI:1457844664
Name:EMMANUEL, SHEENA (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHEENA
Middle Name:
Last Name:EMMANUEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 STONE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-6804
Mailing Address - Country:US
Mailing Address - Phone:717-681-3400
Mailing Address - Fax:
Practice Address - Street 1:4811 JONESTOWN RD STE 129
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-1751
Practice Address - Country:US
Practice Address - Phone:717-526-2011
Practice Address - Fax:717-526-2191
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS041661122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist