Provider Demographics
NPI:1689106023
Name:HENRICKSON, SHEIKH DENTAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:HENRICKSON, SHEIKH DENTAL ASSOCIATES, LLC
Other - Org Name:THE SMILE SHOP NEWTOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KHURRUM
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHEIKH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-968-4400
Mailing Address - Street 1:27 BLACKSMITH RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1870
Mailing Address - Country:US
Mailing Address - Phone:215-968-4400
Mailing Address - Fax:
Practice Address - Street 1:27 BLACKSMITH RD
Practice Address - Street 2:SUITE 101
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1870
Practice Address - Country:US
Practice Address - Phone:215-968-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040706122300000X
PADS022540L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty