Provider Demographics
NPI:1659438463
Name:SAMADDAR, SHEILA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:
Last Name:SAMADDAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 L ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-4410
Mailing Address - Country:US
Mailing Address - Phone:202-547-7747
Mailing Address - Fax:
Practice Address - Street 1:1313 S CAPITOL ST SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3526
Practice Address - Country:US
Practice Address - Phone:202-547-7747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC10001811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice